Dr. Mona Tawakkul Elsayed

Associate Prof. of Mental Health and Special Education

صعوبات التعلم

Learning Disabilities


G. Reid Lyon


Abstract


Approximately 5% of all public school students are identified as having a learning disability


(LD). LD is not a single disorder, but includes disabilities in any of seven areas


related to reading, language, and mathematics. These separate types of learning disabilities


frequently co-occur with one another and with social skill deficits and emotional


or behavioral disorders. Most of the available information concerning learning


disabilities relates to reading disabilities, and the majority of children with learning disabilities


have their primary deficits in basic reading skills.


An important part of the definition of LD is its exclusions: learning disabilities cannot


be attributed primarily to mental retardation, emotional disturbance, cultural difference,


or disadvantage. Thus, the concept of LD focuses on the notion of a


discrepancy


between a child’s academic achievement and his or her apparent capacity to learn.


Recent research indicates, however, that disability in basic reading skills is primarily


caused by deficits in phonological awareness, which is independent of any achievement-


capacity discrepancy. Deficits in phonological awareness can be identified in late


kindergarten and first grade using inexpensive, straightforward testing protocol.


Interventions have varying effectiveness, depending largely on the severity of the individual


child’s disability.


The prevalence of learning disability identification has increased dramatically in the


past 20 years. The “real” prevalence of LD is subject to much dispute because of the


lack of an agreed-upon definition of LD with objective identification criteria. Some


researchers have argued that the currently recognized 5% prevalence rate is inflated;


others argue that LD is still underidentified. In fact, it appears that there are both


sound and unsound reasons for the increase in identification rates.


Sound reasons for the increase include better research, a broader definition of disability


in reading, focusing on phonological awareness, and greater identification of


girls with learning disabilities. Unsound reasons for the increase include broad and


vague definitions of learning disability, financial incentives to identify students for special


education, and inadequate preparation of teachers by colleges of education, leading


to overreferral of students with any type of special need.


There is no clear demarcation between students with normal reading abilities and


those with mild reading disability. The majority of children with reading disabilities


have relatively mild reading disabilities, with a smaller number having extreme reading


disabilities. The longer children with disability in basic reading skills, at any level


of severity, go without identification and intervention, the more difficult the task of


remediation and the lower the rate of success.


Children with extreme deficits in basic reading skills are much more difficult to remediate


than children with mild or moderate deficits. It is unclear whether children in


the most severe range can achieve age- and grade-approximate reading skills, even


with normal intelligence and with intense, informed intervention provided over a pro-


54


The Future of Children SPECIAL EDUCATION FOR STUDENTS WITH DISABILITIES Vol. 6 • No. 1 – Spring 1996


G. Reid Lyon, Ph.D.,


is a psychologist and


director of extramural


research in learning


disabilities, language disorders,


and disorders of


attention at the National


Institute of Child


Health and Human


Development at the


National Institutes of


Health, Bethesda, MD.


55


tracted period of time. Children with severe learning disabilities are likely to manifest


an increased number of and increased severity of social and behavioral deficits. When


children with disabilities in reading also manifest attention deficit disorder, their reading


deficits are typically exacerbated, more severe, and more resistant to intervention.


While severe reading disorders are clearly a major concern, even mild deficits in reading


skills are likely to portend significant difficulties in academic learning. These


deficits, too, are worthy of early identification and intervention. Even children with relatively


subtle linguistic and reading deficits require the expertise of a teacher who is


well trained and informed about the relationships between language development


and reading development. Unfortunately, such teachers are in short supply, primarily


because of a lack of professional certification programs providing this training.


This article focuses primarily on deficits in basic reading skills, both because of their


critical importance to academic success and because relatively more is known about


these deficiencies. However, other academic, social, and behavioral manifestations of


learning disability are also important and cannot be assumed to be adequately


addressed by programs to improve basic reading skills. While early intervention is necessary,


it should not be assumed to be sufficient to address the multiple manifestations


of learning disability.


A



pproximately one-half of all children receiving special education


services nationally, or about 5% of the total public school population,


are identified as having a learning disability (LD) when the federal


definition of LD is used by schools to formulate identification criteria.

1


At the same time, LD remains one of the least understood and most debated


disabling conditions that affect children. Indeed, the field continues to


be beset by pervasive, and occasionally contentious, disagreements about


the definition of the disorder, diagnostic criteria, assessment practices, treatment


procedures, and educational policies.

2–6


Learning disability is not a single disorder, but is a general category


of special education composed of disabilities in any of seven specific areas:


(1) receptive language (listening), (2) expressive language (speaking),


(3) basic reading skills, (4) reading comprehension, (5) written expression,


(6) mathematics calculation, and (7) mathematical reasoning. These


separate types of learning disabilities frequently co-occur with one another


and also with certain social skill deficits and emotional or behavioral disorders


such as attention deficit disorder. LD is not synonymous with reading


disability or dyslexia although it is frequently misinterpreted as such.

7,8


However, most of the available information concerning learning disabilities


relates to reading disabilities, and the majority of children with LD have


their primary deficits in reading.

2


Box 1 shows the statutory definition of learning disabilities contained in


the Individuals with Disabilities Education Act (IDEA). An important part of


56 THE FUTURE OF CHILDREN – SPRING 1996


the definition of learning disabilities under the IDEA is the exclusionary language:


learning disabilities cannot be attributed primarily to mental retardation,


emotional disturbance, cultural difference, or environmental or


economic disadvantage. Thus, the concept of learning disabilities embedded


in federal law focuses on the notion of a discrepancy between a child’s


academic achievement and his or her apparent capacity and opportunity to


learn. More succinctly, Zigmond notes that “learning disabilities reflect


unexpected learning problems in a seemingly capable child.”

9


Although poverty and disability are often found together and each tends


to exacerbate the other (see the article by Wagner and Blackorby in this


journal issue), Congress has established separate programs to serve children


with disabilities (the IDEA) and children in poverty (Title 1). Title 1 of the


Elementary and Secondary Education Act provides funding for supplemental


programs in schools serving large numbers of economically disadvantaged


children. Because individual children with disabilities have strong


entitlements to services under the IDEA, Congress’s intent was that the


IDEA serve only children with “true disabilities” and that the IDEA specifically


exclude those students whose underperformance is primarily attributable


to poverty. However, in the category of learning disability, and perhaps


also in the category of mental retardation, this distinction is difficult or


impossible to draw, and no empirical data exist to support this exclusionary


practice.


While there is some agreement about these general concepts, there is


continued disagreement in the field about diagnostic criteria, assessment


practices, treatment procedures, and educational policies for learning disabilities.


A number of influences have contributed to these disagreements


which, in turn, have made it difficult to build a generalizable body of scientific


and clinical knowledge about learning disabilities and to establish reliable


and valid diagnostic criteria.

4,5 While some progress has been made


during the past decade in establishing more precise definitions and a theoretically


based classification system for LD,

8–10 it is useful to understand


these historical influences because of their continuing impact on diagnostic


and treatment practices for children with learning disabilities.


Definition of Learning Disability Under


the Individuals with Disabilities Education Act


“Specific learning disability” means a disorder in one or more basic psychological processes


involved in understanding or in using language, spoken or written, that may manifest itself


in an imperfect ability to listen, speak, read, write, spell, or to do mathematical calculations.


The term includes such conditions as perceptual disabilities, brain injury, minimal brain


dysfunction, dyslexia, and developmental aphasia. The term does not apply to children


who have learning problems that are primarily the result of visual, hearing, or


motor disabilities, of mental retardation, of emotional disturbance, or of environmental,


cultural, or economic disadvantage.


Source:


Code of Federal Regulations, Title 34, Subtitle B, Chapter III, Section 300.7(b)(10).


Box 1


Learning Disabilities 57


The next section of this article reviews briefly the historical events that


have molded the field of learning disabilities into its present form.


Subsequent sections address issues related to the prevalence of learning disabilities,


the validity of current prevalence estimates, impediments to the


identification and teaching of the child with LD, advances in identification,


classification, intervention practices in the area of reading disability, comorbidity


of types of learning disabilities (reading, written expression, mathematics


disabilities) with disorders of attention and social skills deficits,


outcomes for individuals with learning disabilities, and the implications for


teacher preparation and school policies.


Historical Influences


The study of learning disabilities was initiated


in response to the need (1) to understand


individual differences among children


and adults who displayed


specific deficits in


spoken or written language while maintaining


integrity in


general intellectual functioning


and (2) to provide services to these


students, who were not being adequately


served by the general educational system.


6,9,10


Overall, the field of learning disabilities


emerged primarily from a social


and educational need and currently remains


a diagnostic practice that is more rooted in


clinical practice, law, and policy than in science.


Advocates for children with learning


disabilities have successfully negotiated a


special education category as a means to


educational protection at the same time that


the schools have seen an increase in the


identification of LD.


6


The unexpected pattern of


general


strengths and


specific weaknesses in learning


was first noted and studied by physicians


during the early twentieth century,


thus giving the field its historical biomedical


orientation.


10 Doctors noted that children


with learning disabilities were similar


to adults and children with focal brain


damage in that specific impairments in


some areas of learning could occur without


diminishing strengths in general cognitive


ability.


Although the clinical work conducted


during the first half of the twentieth century


recognized the existence of learning disabilities,


such information had little influence


on public school policies until the


mid-1960s. At this time, behavioral scientists,


educators,


11 and parents expressed


concern that some children had learning


handicaps that were not being served effectively


by general educational practices.


9 At


the same time, these children were ineligible


for special education services because


their characteristics did not correspond to


any recognized categories of disability. This


disenfranchisement stimulated an advocacy


movement to provide special educational


services to students with learning disabilities,


4,6,9


leading many states to establish a


special education category for LD during


the late 1960s and 1970s.


Prevalence


The influence of advocacy has, in turn, contributed


to a substantial proliferation in the


number of children who have been identified


with learning disabilities relative to other


handicapping conditions (see Figure 1).


Clearly, the prevalence of LD identification


has increased dramatically.


The “real” prevalence of learning disabilities


is subject to much dispute because


of the lack of an agreed-upon definition


of LD and objective diagnostic criteria.


4,8,12


Some have argued that the currently recognized


5% prevalence rate is excessive


and is based on vague definitions, leading


to inaccurate identification. On the other


hand, research efforts to identify objective


early indicators of LD in basic reading


skills have concluded that virtually all children


scoring below the 25th percentile on


standardized reading tests can meet the


criteria for having a reading disorder.


12


While less is known about LD in written


expression, researchers estimate its true


prevalence at between 8% and 15% of


the school population.


13 Research also


indicates that approximately 6% of the


school population has difficulties in mathematics


which cannot be attributed to low


intelligence, sensory deficits, or economic


deprivation.


14


58 THE FUTURE OF CHILDREN – SPRING 1996


Increase in Identification


The substantial increase in the identification


of children with learning disabilities shown


in Figure 1 has led many to question the


validity and reliability of LD as a diagnostic


category or its “realness” as a handicapping


condition.


15 In fact, it appears likely that


there are both sound and unsound reasons


for the increase, as is discussed later.


It should be made clear that difficulties


in the identification of children with learning


disabilities do not make the disabilities


any less “real” to the student who cannot


learn to read, write, or understand mathematics


despite good intelligence, an adequate


opportunity to learn, and ostensibly


good teaching. However, such an anecdotal


understanding of learning disability and its


prevalence seems inadequate now, given the


increase in diagnoses of LD, the consequences


of learning failure in children, and


the tremendous financial resources that are


applied to the identification and teaching of


children with learning disabilities. Given


what is at stake, it is critical that the construct


of learning disability and procedures for


identifying children and adults with LD be


valid and accepted by the scientific and clinical


communities.


The question remains, however, of how


to go about increasing the ability to identify


individuals with LD accurately. Valid prevalence


estimates depend upon a set of criteria


for identification that are clear, observable,


measurable, and agreed upon.


The Discrepancy Standard


There is currently no universally accepted


test, test battery, or standard for identifying


children with LD. While a discrepancy


Source: Office of Special Education Programs.


Implementation of the Individuals with Disabilities Education Act: Fifteenth


Annual Report to Congress.



Washington, DC: U.S. Department of Education, 1993.


Figure 1


Percentage of Children Identified as Manifesting the Most


Common Disabilities in the Years 1977 through 1993


n n n n n n n n n n n n n n n n n


J



l l l


l l l l l l l l l l l l


l


s


s s s s s s s s s s s s s s s s


l


u


u


u


u


u


u u


u u u u


u u u


u u


1976-77


1977-78


1978-79


1979-80


1980-81


1981-82


1982-83


1983-84


1984-85


1985-86


1986-87


1987-88


1988-89


1989-90


1990-91


1991-92


1992-93


0


1


2


3


4


5


6


Percent


School Year


n



Serious Emotional Disturbance


  l



Mental Retardation


s



Speech/Language


u



Specific Learning Disability


Learning Disabilities 59


between intelligence quotient (IQ) and


achievement has been a widely accepted criterion


for the identification of LD and still


serves as the driving clinical force in the


diagnosis of LD, there is considerable variation


in how the discrepancy is derived and


quantified.


9,16 Federal regulations and


extant clinical criteria


17 do not specify particular


formulas or numerical values to assess


discrepancy objectively. The effect of this


lack of specification on both clinical and


research practices is substantial. From a clinical


standpoint, a child can be identified as


having a learning disability in one school district


but not in a neighboring district


because of differences in the measure of discrepancy


used. From a research perspective,


different approaches to the discrepancy


measurement lead to substantially different


sample characteristics and different prevalence


estimates, which undermine the ability


to replicate and generalize findings.


5,6,8,9


For the individual child, use of the discrepancy


standard clearly promotes a wait-tofail


policy because a significant discrepancy


between IQ and achievement generally cannot


be detected until about age eight or


nine. In fact, most school districts do not


identify children with learning disabilities


until a child is reading well below grade level,


generally in third or fourth grade.


18 By this


time the child has already experienced at


least a few years of school failure and probably


has experienced the common attendant


problems of low self-esteem, diminished


motivation, and inadequate acquisition of


the academic material covered by his classmates


during the previous few years.


It is clear that the longer children with


learning disabilities, at any level of severity,


go without identification and intervention,


the more difficult the task of remediation


becomes and the harder it is for the children


to respond. Specifically, the data strongly


suggest that children at risk for reading failure


should be identified before the age of


nine if successful intervention results are to


be anticipated.


13 For example, a longitudinal


investigation of 407 students


19 found that


74% of the children whose disability in reading


was first identified at nine years of age or


older continued to read in the lowest quintile


throughout their middle and high


school years. In addition, the longer children,


at all severity levels, are faced with failure


in reading in the classroom setting, the


greater the probability that comorbid learning


and behavioral difficulties will arise, further


complicating the remediation task.


Developing a Diagnostic


Standard


If current definitions of learning disability


are not useful and if the discrepancy standard


is a poor one, why have schools not


adopted other means of defining and identifying


LD? There are a number of conceptual


and methodological barriers to the


accurate identification of learning disabilities,


and these impediments lead to confusion


about definitions, diagnostic issues, and


rising prevalence rates.


Multidisciplinary Nature of the Field


Opinions about what constitutes a learning


disability vary


6,10 in part because LD is the


concern of many disciplines and professions,


including education, psychology, neurology,


neuropsychology, optometry, psychiatry, and


speech and language pathology, to name a


few. Each of these disciplines has traditionally


focused on different aspects of the child or


adult with learning disability, so divergent


ideas and contentious disagreements exist


about the importance of etiology, diagnostic


methods, intervention methods, and professional


roles and responsibilities.


10 It is not


surprising that so many children are identified


because each professional may view the


child through his or her own idiosyncratic


clinical lens. For example, optometrists may


identify a child as having a learning disability


if the youngster displays difficulties in visual


tracking. Speech and language pathologists,


on the other hand, become concerned if the


child’s vocabulary and syntactic development


are not commensurate with expectations.


Educators become concerned primarily


when development in reading, writing,


and mathematics is deficient.


Lack of Specific Identification Criteria


Probably the most significant and persistent


problem in the field is the lack of a precise


definition and a theoretically based classification


system that would allow (1) the


identification of different types of learning


disabilities and (2) a means of recognizing


distinctions and interrelationships between


types of learning disabilities and other learning


disorders such as mental retardation,


attention deficit disorder, speech and lan


60


THE FUTURE OF CHILDREN – SPRING 1996


guage difficulties, and general academic


underachievement.


20 At present, the field


continues to construct and use vague and


ambiguous definitions that rely heavily on


the exclusion of alternative diagnoses, such


as the IDEA definition shown in Box 1.


Overly Broad Label


Some observers argue that the term “learning


disability” is too broad to be of any diagnostic


value. Stanovich,


16 a leading proponent


of this view, proposes that the general


term learning disabilities be abandoned and


that definitional and research efforts focus


on the specific types of disabilities that are


now identified in ambiguous terms.


As noted earlier, the generic term learning


disabilities encompasses disabilities in


seven categories: (1) listening, (2) speaking,


(3) basic reading skills, (4) reading comprehension,


(5) written expression, (6) mathematical


calculation, and (7) mathematical


reasoning. Given the complexity and heterogeneity


of each of these disabilities, it


seems unrealistic to expect that any definitional


clarity can be achieved by grouping


them together under one label. To do so


only obscures the critical features of each


disability and makes research findings difficult


to interpret.


Definitions of specific learning disabilities


can be more easily and successfully operationalized


than generic definitions, as the


research on disability in basic reading skills


shows.


8 To establish valid prevalence estimates


for the number of individuals with


learning disabilities, the first step should be


to establish explicit diagnostic criteria for


each



of the seven specific disability domains.


At present, the greatest progress toward this


goal has been in the area of disability in basic


reading skills.


8


LD as a Sociological Phenomenon


The simplest explanation for the increasing


numbers of children identified with learning


disabilities and for the difficulty in


understanding and defining LD is that


“LD” is not a distinct disability, but an


invented category created for social purposes.


Some argue that the majority of students


identified as having learning disabilities


are not intrinsically disabled but have


learning problems because of poor teaching,


lack of educational opportunity, or limited


educational resources.


15 In addition,


because the label of LD is not a stigmatizing


one, parents and teachers may be more


comfortable with a diagnosis of LD than


with labels such as slow learner, minimal


brain dysfunction, or perceptual handicap.


A diagnosis of LD does not imply low intelligence,


emotional or behavioral difficulties,


sensory handicaps, or cultural disadvantage.


Thus, more positive outcomes are


expected for children with learning disabilities


than for those with mental retardation


or emotional disturbance.


Reasons for Increase in


Identification of LD


As pointed out, the substantial increase in the


identification of LD, as shown in Figure 1,


has caused many researchers to question


the validity of the data. No doubt, the failure


to develop an agreed-upon, objective,


operational definition of learning disability


gives credence to the concern about the


validity of the identification process. Thus,


it seems reasonable to assume that at least


some of the increase in prevalence can


be linked to conceptual, methodological,


social, and political factors that spuriously


inflate the identification of children with


learning disabilities.


5 However, despite the


conceptual and methodological shortcomings


that have plagued the field with


respect to definition and identification


practices, there exist a number of possibly


sound reasons that could account for an


increase in the number of children identified


with LD.


Some Sound Reasons


As knowledge about learning disabilities


grows, some academic difficulties not previously


recognized as LD can be identified as


such. Greater knowledge also affects the


behavior and practices of teachers and parents.


Sound reasons for the increase in identification


rates are described and discussed


in the sections that follow.


n


Better Research. Research in the past decade


measures underachievement in reading as it


occurs naturally in large population-based


samples


12,13 rather than as identified by


schools, which use widely varying criteria. In


addition, much of this new research is longitudinal


and has been replicated, providing


the necessary foundation for epidemiological


studies.


2,12,13,19,21–24 Finally, many of these


Learning Disabilities 61


studies have been specific to LD in reading,


rather than LD in general, allowing greater


precision.


n


Broader Definitions. Prevalence is directly


linked to definition. LD in reading has been


defined in recent research as


significant difficulties


in reading single words accurately and fluently,


in combination with deficits in phonological


awareness



.8 Using this definition and stronger


longitudinal research methods outlined


above, the prevalence for reading disability


alone has increased from estimates of less


than 5% in l976 to approximately 17% in


l994.


12


Phonological awareness is a critical


attribute in learning to read, and children


who lack this awareness can be identified


in late kindergarten and early first grade.


Typical diagnostic questions for kindergartners


or first graders involve rhyming skills


(for example, “Tell me three words that


rhyme with ‘cat’”) and phoneme deletion


skills (for example, “Say ‘cat’ without the


/t/ sound”). The majority of children pick


up phonological awareness skills easily by


six to seven years of age, but a large minority


of children (about 17%) have significant


difficulty with these skills and will have


great difficulty learning to read, regardless


of their intelligence, unless these skills are


acquired.


n


Identification of LD in Girls. A substantial


portion of this increase can be attributed


to the fact that females have been found


to manifest reading disabilities at rates


equal to males, in contrast to previous


reports that males with reading disabilities


outnumbered females with reading disabilities


at a ratio of four to one.


25 This


finding necessarily increases the prevalence


rate.


n


Increased Awareness. Information disseminated


in the past decade, particularly concerning


the characteristics of reading


disability, has increased the number of children


referred for assessment of a learning


disability.


6


n


Understanding of the Impact. There has


been an increase in the recognition that


even “mild” deficits in reading skills are


likely to portend significant difficulties in


academic learning and are, therefore, worthy


of early identification, diagnosis, and


intervention.


26,27


Some Unsound Reasons


There is no shortage of horror stories about


the misidentification of LD and reports that


the category serves as a “catch all” for any


youngster who is not meeting the expectations


of parents and teachers. Are there legitimate


reasons for these criticisms? The


© Harry Cutting


answer appears to be yes. Examples are


described and discussed in the sections that


follow.


n


Ambiguous Definitions. The ambiguity


inherent in the general definitions of LD (see


Box 1) leaves the identification process open


for wide interpretation and misinterpretation.


Flexible identification decision making


allows some children to be identified as having


learning disabilities when they do not,


while others with learning disabilities may be


overlooked.


5 This latitude can be manipulated


to increase prevalence rates in response to


financial incentives (for example, to qualify


for increased state funding), to decrease


prevalence rates in response to political


movements (for example, inclusion), or to


abandon programs that appear too costly.


28


n


Social and Political Factors. Social and political


factors also contribute to the inflation of


prevalence rates for learning disabilities. In


l976–77, the first year of full implementation


of Public Law 94–142, 2.16% of all schoolchildren


were served in programs for children


with mental retardation (MR) and


1.80% in programs for children with learning


disabilities (Figure 1). By the l992–93 school


year, placements for children with MR had


decreased to 1.1% while placements for children


with LD had increased to 5.4% of the


total school population (Figure 1). While


these reversed trends mask substantial variations


among states, the dramatic changes in


identification rates of the two types of disability


suggest that attempts to apply less stigmatizing


labels may be influencing the identification


process.


n


Number of Professional Specialties Involved.


The large number of professional specialties


involved in the identification process provides


fertile ground for the overidentification


of LD because each specialty brings its


own set of diagnostic assumptions, theories,


and measures to the assessment task.


Inconsistent identification practices allow


prevalence rates to escalate. This is a significant


problem when there are financial


incentives to encourage identification (see


the article by Parrish and Chambers in this


journal issue). Both market and legal forces


can stimulate the development of new professional


specialties (such as language/learning


disorder specialist) whose members have


financial incentives to diagnose students with


learning disabilities, which the specialists will


often be employed to treat. Although it may


be uncomfortable to mention these factors,


they exist and play some role in the increase


of prevalence of LD. At the same time, the


majority of professionals serving children


with learning disabilities appear well intentioned


and well informed.


n


Inadequate Preparation of Teachers.


Unfortunately, a major factor contributing


to invalid prevalence estimates may be the


inadequate preparation of teachers by colleges


of education. Recent studies have


found that a majority of regular classroom


teachers feel that they are not prepared to


address individual differences in learning


abilities within classroom settings.


29 Even


more alarming, research suggests that special


educators themselves do not possess sufficient


content knowledge to address the


language and reading needs of children


with learning disabilities.


30 Without adequate


preparation, teachers have a tendency


to overrefer children for specialized assistance


because they feel ill-equipped to provide


the necessary services.


31


Interpreting Prevalence Rates


The prevalence of learning disabilities is


completely dependent upon the definition


used. In most areas, the identification of LD


is based largely upon the discrepancy standard


and, thus, provides a count of the number


of older elementary students (third


grade and above) who are achieving significantly


below expectations based on IQ. This


is, at best, an incomplete definition of LD


and one that, for the majority of students


with learning disabilities, is based upon an


invalid criterion, namely, the discrepancy


standard.


Clearly, current definitions allow both


overidentification and underidentification


of LD. Depending upon the magnitude of


62 THE FUTURE OF CHILDREN – SPRING 1996


Both market and legal forces can stimulate


the development of new professional


specialties whose members have financial


incentives to diagnose students with


learning disabilities.


Learning Disabilities 63


financial incentives and upon unrelated factors


(for example, class size, goals for


increasing test scores) that often shape the


decisions of classroom teachers to refer students


with special needs, an individual


school district may drastically overidentify or


underidentify students with learning disabilities.


Therefore, local or national statistics on


identification rates for students with LD


must be interpreted with caution.


Efforts to Improve


Identification


To improve the diagnosis and remediation


of learning disabilities, a classification system


is needed to identify different types of learning


disabilities as well as the distinctions and


interrelationships among types of LD and


other childhood disorders.


2,20,32 Prospective


longitudinal studies are one of the most


powerful means to study the different types


of LD and their relationships to other disorders


and to obtain data for a focused and


succinct definition.


Prospective, longitudinal studies of LD


can serve as a platform to (1) identify critical


learning and behavioral characteristics


that may be manifested in different ways at


different developmental periods, (2) develop


early predictors of underachievement


for different academic domains (for


example, reading, written language, math),


(3) map the developmental course of different


types of learning disabilities, (4) identify


commonly co-occurring disorders and


secondary behavioral consequences that


develop in response to failure in school, and


(5) assess the efficacy of different treatment


and teaching methods for different types of


learning disabilities.


To address this compelling need to


establish a valid classification system and


definition for LD, Congress enacted the


Health Research Extension Act of l985


(Public Law 99–158). This act called for


the development of an Interagency Committee


on Learning Disabilities (ICLD),


under the lead of the National Institute of


Child Health and Human Development


(NICHD), to identify critical research


needs in LD and to implement comprehensive


studies to address issues relevant to


identification, prevention, etiology, and


treatment.


New Knowledge of


Reading Disabilities


Since the inauguration of the NICHD


Learning Disability Research Network in


l987, researchers have learned the most


about learning disabilities that affect linguistic,


reading, and spelling abilities and the


least about learning disabilities in mathematics.


2


A number of new findings have also


been obtained in the area of attention deficit


disorder (ADD) and its relationship to different


types of LD, particularly disorders in


reading.


12 For brevity, the major discoveries


made during the past several years are presented


in Table 1. Selected findings are


reviewed here. The reader should note that


many findings have been replicated by multiple


research groups, as cited in Table 1, and


that the findings are primarily based on large


longitudinal samples. Finally, readers should


note that studies being conducted in Canada


by Stanovich and Siegel at the Ontario


Institute for Studies in Education are included


in Table 1 because of their impact on the


field and because Stanovich and Siegel serve


as consultants to the Yale Learning Disability


Research Center (LDRC).


As Table 1 shows, a majority of discoveries


made during the past decade have been


in the area of reading disabilities. This is


appropriate. As Lerner pointed out from


her analysis of public school referral data in


1989,


33 approximately 80% of children identified


as having learning disabilities have


their primary difficulties in learning to read.


This high rate of occurrence of reading difficulties


among youngsters with LD has also


been reported by Kavale in his meta-analytic


studies.


34 More recent longitudinal and


cross-sectional studies have supported the


high rate of reading difficulty among children


with learning disabilities, but have also


found that reading deficits frequently cooccur


with other academic and attentional


difficulties. For example, Fletcher and his


associates at the Yale Center for the Study of


Learning and Attention have, as part of a


Approximately 80% of children identified


as having learning disabilities have their


primary difficulties in learning to read.


64 THE FUTURE OF CHILDREN – SPRING 1996


Research Research


Domain Findings Group*


Definition Definitions that measure the discrepancy between IQ and achievement Yale


of learning do not adequately identify learning disabilities, particularly in the area Ontario


disabilities of basic reading skills.


Reading Disabled readers with and without an IQ-achievement discrepancy Colorado


processes show similar information processing, genetic, and neurophysiological Bowman Gray


profiles. This indicates that the existence of a discrepancy is not a Yale


valid indicator of disability in basic reading skills. Ontario


Reading Epidemiological studies indicate that as many females as males manifest Bowman Gray


processes dyslexia; however, schools identify three to four times more boys than girls. Colorado


Yale


Reading Reading disabilities reflect a persistent deficit rather than a developmental lag. Yale


processes Longitudinal studies show that, of those children who are reading disabled Ontario


in the third grade, approximately 74% continue to read significantly below


grade level in the ninth grade.


Reading Children with reading disability differ from one another


and from other Yale


processes readers along a continuous distribution. They


do not aggregate together Bowman Gray


to form a distinct “hump” separate from the normal distribution. Colorado


Ontario


Reading The ability to read and comprehend depends upon rapid and automatic Yale


processes recognition and decoding of single words. Slow and inaccurate decoding Bowman Gray


are the best predictors of deficits in reading comprehension. Colorado


Johns Hopkins


Florida


Houston


Reading The ability to decode single words accurately and fluently is dependent Yale


processes upon the ability to segment words and syllables into phonemes. Deficits Colorado


in phonological awareness reflect the core deficit in dyslexia. Bowman Gray


Miami


Johns Hopkins


Florida


Houston


Reading The best predictor of reading ability from kindergarten and Bowman Gray


processes first-grade performance is phoneme segmentation ability. Yale


Florida


Houston


Attention A precise classification of disorders of attention is not yet available; Yale


however, operational definitions are emerging.


Attention Approximately 15% of students with reading disability also have a Bowman Gray


disorder of attention. Approximately 35% of students with disorders Yale


of attention also have reading disability. However, the two disorders


are distinct and separable.


Table 1


Major Findings from Research Programs Supported by the


National Institute of Child Health and Human Development


*See the related endnote at the end of this article for a detailed description of research groups.


larger classification effort, studied 216 children,


7.5 to 9.5 years of age, who were identified


as normal readers, reading disabled,


math disabled, both reading and math


disabled, normal reading with ADD, and


reading disabled with ADD.


21,35 From this


sample of children with a variety of learning


disabilities, only 25 youngsters were reading


at age-appropriate levels.


Research indicates that reading disorders


reflected in deficient decoding and


word-recognition skills are primarily caused


by deficiencies in the ability to segment syllables


and words into constituent sound


units called phonemes.


16,22,36–38 For example,


in a large study of 199 seven- to nineyear-


old children who had significant difficulties


in decoding and word recognition,


more than 85% of the youngsters manifested


deficits on measures of phonological


awareness. In this investigation, children


with and without IQ-reading-achievement


discrepancies appeared equally impaired


on both the phonological and reading measures.


21


This extremely high frequency of


phonological awareness deficits in children


with reading disabilities has led Share and


Stanovich to conclude: “We know unequivocally


that less-skilled readers have difficulty


turning spellings into sounds. . . . This relationship


is so strong that it deserves to be


identified as one, if not the defining, feature


of reading disability.”


39


Biological Bases


Several NICHD investigations have indicated


that these phonologically based reading


disabilities are linked to neurobiological


and genetic factors.


2,8,13,40 Functional and


structural neuroimaging studies indicate


that the poor phonological skills, which


limit the development of basic reading abilities,


are highly related to aberrant neurophysiological


processing.


22,40 Moreover,


there is increasing evidence from behavioral


and molecular genetic studies that the


phonological deficits observed in reading


disability are heritable.


41,42 Taken together,


longitudinal studies of the linguistic, neurobiological,


and genetic factors in reading


disabilities provide strong and converging


Learning Disabilities 65


Research Research


Domain Findings Group*


Attention Disorders of attention exacerbate the severity of reading disability. Bowman Gray


Miami


Genetics There is strong evidence for a genetic basis for reading disabilities, with Colorado


deficits in phonological awareness reflecting the greatest degree of Bowman Gray


heritability.


Neurology Regional blood studies indicate that deficient word recognition skills are Bowman Gray


associated with less than normal activation in the left temporal region.


Neurology PET studies indicate that dyslexic adults have greater than normal Miami


activation in the occipital and prefrontal regions of the cortex.


Intervention Disabled readers do not readily acquire the alphabetic code because of Bowman Gray


deficits in phonological processing. Thus, disabled readers must be Florida


provided highly structured programs that explicitly teach application Houston


of phonological rules to print.


Intervention Longitudinal data indicate that systematic phonics instruction results in Bowman Gray


more favorable outcomes for disabled readers than does a context- Florida


emphasis (whole language) approach. Houston


Table 1

(continued)


Major Findings from Research Programs Supported by the


National Institute of Child Health and Human Development


*See the related endnote at the end of this article for a detailed description of research groups.


66 THE FUTURE OF CHILDREN – SPRING 1996


evidence that reading disability is primarily


caused by deficits in phonological processing


and, more specifically, phonological


awareness.


8,13,30,37,38,40


Likewise, the data derived from genetic


and neurobiological studies suggest that


some reading disabilities are associated with


subtle chromosomal


42 and neurological differences,


22,40


indicating that such disabilities


are biologically “real” rather than sociopolitically


created.


Discrepancy Standard


In addition to the previously discussed problems


of the discrepancy standard, Table 1


indicates that the use of a discrepancy formula,


which calculates differences between


IQ and reading scores, is not a valid indicator


of reading disability; that is, children with


reading disabilities both with and without


such discrepancies have similar deficits in


phonological awareness and similar genetic


and neurophysiological characteristics.


36 At


this time, it is not clear whether children


with higher IQs respond more favorably to


intervention.


7


Persistent Deficit


Unfortunately, as Table 1 indicates, reading


disabilities appear to reflect a persistent


deficit rather than a developmental lag.


That is, children with delays in understanding


phonological concepts in first grade are


unlikely to catch up later without explicit


and informed teaching. Longitudinal studies


show that, of the youngsters who are


identified in the third grade, approximately


74% remain reading disabled through the


ninth grade.


19,43 This appears to be true even


when special education has been provided.


It should be made clear, however, that interventions


applied


after a child has failed in


reading for two or three years may not be


effective for several reasons, including the


student’s declining motivation and impaired


self-concept. Instructional difficulties in later


intervention abound. For example, the


teacher carrying out the interventions may


not be properly trained, the interventions


may not include explicit and informed


instruction in the development of phonological


awareness and sound-symbol relationships,


the interventions may not be consistently


applied and/or may be limited in


intensity and duration, and there may be


insufficient follow-up or explicit instruction


to enable the student to generalize the specific


concepts learned to material presented


in regular classroom settings.


Distribution of Severity


A significant finding from the Yale LDRC


is that reading disability represents the


extreme of a normal distribution of reading


ability so that there is an unbroken continuum


from reading ability to reading disability.


43


The finding that reading disability is


part of a continuum now places the disorder


in the context of other biologically


based disorders such as hypertension and


obesity.


43 The discovery that reading disability


is best conceptualized as occurring along


a normal distribution of reading skills


underscores the fact that children will vary


in their level of severity of the disorder running


along a mild-to-severe spectrum, with


the majority of children with reading disabilities


falling at the mild end. This finding


has significant implications. For example,


what are the criteria for identifying a child


as having a


severe reading disability, and does


this degree of disability warrant entitlement


to a greater intensity and duration of specialized


interventions?


To answer such questions, the NICHD is


embarking on a series of studies to identify


the most valid points along the distribution


of reading scores that distinguish levels of


severity. In part, the validity of different cutoff


points for mild, moderate, and severe


reading disability is being determined by


how children in each severity group respond


to different types and intensities of intervention.


At this writing, some initial results


derived from the Florida State Intervention


Project show that children with scores at the


extreme lower end of the distributions for


both phonological awareness skills and basic


reading skills are much more difficult to


remediate than children who fall along the


distribution in the mild and moderate


Interventions applied



after a child has


failed in reading for two or three years may


not be effective for several reasons, including


the student’s declining motivation and


impaired self-concept.


Learning Disabilities 67


ranges.


44–46 It is as yet unclear whether children


in the more severe range can achieve


age- and grade-approximate reading skills,


even with intense, informed intervention


provided over a protracted period of time.


While children with severe reading disabilities


will most likely require a greater


amount of time in high-impact intervention


programs than children with less severe


deficits, as discussed earlier, it is clear that


the longer children


at any level of severity go


without proper identification and intervention,


the more difficult the task of remediation


and the harder it becomes for the children


to respond. It is also clear that even


children with relatively subtle linguistic and


reading deficits require the expertise of a


teacher who is well trained and informed


about the relationships between language


development and reading development.


30


Unfortunately, such teachers are in short


supply, primarily because of a lack of programs


providing this training.


31


Co-occurring Disorders


As noted, most children with learning disabilities


have more than one of the seven


subtypes of learning disabilities. It is also not


unusual to find LD co-occurring with certain


behavioral or emotional disorders. The most


common co-occurring combinations are discussed


briefly below.


Reading and Attention Disorders


Attention deficit disorder (ADD) is an


increasingly common diagnosis recognized


in medicine


47 and psychology17 although it is


not a category of disability recognized under


the IDEA. Like LD, ADD is the subject of


considerable controversy, and diagnostic criteria


for ADD continue to evolve. There is


no litmus test for ADD, which is diagnosed


on the basis of persistent and maladaptive


behavior patterns (inattention, impulsivity,


and hyperactivity) that are inappropriate for


the child’s age. The number of diagnoses of


ADD has increased dramatically in the past


decade,


48 and one study12 found 7% of a survey


sample of 445 kindergarten students


qualifying as “inattentive” on the Multigrade


Inventory for Teachers.


Figure 2


12 indicates that a child identified


with reading disabilities is twice as likely as a


member of the general population to also


meet the diagnostic criteria for inattention


(15% versus 7%). Similarly, an individual


diagnosed with ADD is at higher risk than a


member of the general population of having


a reading disability/phonological awareness


deficit (36% versus 17%). Despite this cooccurrence,


recent studies have indicated


that reading disabilities and ADD are distinct


and separable disorders.


12,22.49


Unfortunately, when children with disabilities


in reading also manifest ADD, their


reading deficits are typically exacerbated,


more severe, and more resistant to intervention.


22


In contrast to reading disabilities,


ADD is more prevalent in males. Given the


frequent co-occurrence of ADD with reading


disabilities and given the tendency of


boys with ADD to attract considerable attention


from teachers, this combination may


make boys with disabilities in reading much


more likely than girls with disabilities in


reading to come to the attention of teachers


and to be referred for testing.


Social Adjustment Problems


In a broad sense, data indicate that learning


disability, no matter what the specific type,


has a tendency to co-occur with social adjustment


problems.


50 Bruck,51 in her review of


the literature related to social and emotional


adjustment, concluded that children with


learning disabilities are more likely to exhibit


increased levels of anxiety, withdrawal,


depression, and low self-esteem compared


with their nondisabled peers. This comorbidity


is persistent. For example, Johnson


and Blalock


52 found that, of the 93 adults


studied in an LD clinic sample, 36% continued


to receive counseling or psychotherapy


for low self-esteem, social isolation, anxiety,


depression, and frustration. In many


instances, it appears that such emotional


problems reflect adjustment difficulties


resulting from academic failure.


13 Deficits


in social skills have also been found to exist


at significantly high rates among children


with learning disabilities.


53 In general, social


skill deficits include difficulties interacting


with people in an appropriate fashion (for


Even children with relatively subtle linguistic


and reading deficits require the expertise of


a teacher who is well trained.


example, lack of knowledge of how to greet


people, how to make friends, and how to


engage in playground games or a failure to


use knowledge of such skills in these situations).


While not all children with learning


disabilities exhibit deficits in social skills,


there are certain common characteristics


among those who do. For example, Bruck


51


reported that children with more severe


manifestations of LD are likely to manifest


both an increased number of and increased


severity of social skills deficits. Moreover, the


gender of the child appears to be a factor,


with evidence suggesting that girls with LD


are more likely to have social adjustment


problems.


51


Reading Disorders with Other


Learning Disabilities


There is abundant evidence that it is rare for


a child with learning disabilities to manifest


only one specific type of learning disability.


3,53


The co-occurrence of learning disorders


should be expected given the developmental


relationships between listening,


speaking, reading, spelling, writing, and


mathematics. For example, it is clear that


deficits in phonological awareness lead to


difficulties in decoding and word recognition


which, in turn, lead to deficits in reading


comprehension.


16,37,38 Likewise, children


with disabilities in reading frequently experience


persistent difficulties in solving word


problems in math for the obvious reason


that the printed word is difficult for them to


comprehend.


14


An important conclusion to draw from


the literature on co-occurring disorders is


that any intervention or remediation effort


must take into account the range of deficits


a child may have. More specifically, while an


intensive reading intervention may consist


of explicit instruction in phonological


awareness, sound-symbol relationships, and


contextual reading skills, the child may also


require elements essential to bolstering selfesteem,


and to fostering reading in other


content areas such as mathematics, social


studies, and science. One cannot expect the


intervention for the reading deficit to generalize


serendipitously to other domains of


difficulty.


LD in Written Expression


Typically, children who display LD in written


expression have difficulties in spelling,


formulation and expression of ideas,


handwriting, and knowledge of grammar


and syntax. Unfortunately, well-designed


research investigating disorders of written


expression is relatively meager. Definitions


for disorders of written expression remain


vague.


54 Therefore it is not surprising that


estimates of the prevalence of such disorders


range from 8% to 15%.


13 What is


known is that boys and girls display written


language deficits at relatively equal


rates.


54 Despite the lack of objective and


detailed identification criteria, a number


of excellent studies have been conducted


to identify effective assessment and intervention


programs for problems in written


expression.


55–57


The most successful programs tend to


ensure that clear linkages are drawn between


oral language, reading, and written language.


Successful programs also ensure


that basic skills development in spelling


and writing (graphomotor production) are


explicitly taught and/or accommodated


and that the student is also taught how to


employ strategies to guide the formulation


of ideas for writing and the organization of


these ideas in writing. These elements are


common to many writing programs; however,


successful instruction for students with


disabilities in written expression depends


upon their intensity and explicitness.


LD in Mathematics


Children identified as manifesting LD in


mathematics can demonstrate deficits in


arithmetic calculation, mathematics reasoning,


or both. In general, authorities


agree that approximately 6% of the school


population have difficulties in mathematics


that cannot be attributed to low intelligence,


sensory deficits, or economic deprivation.


14,58


While the data are sparse at this


time, it appears that deficits in arithmetic


calculation skills are more frequently


identified than deficits in arithmetic reasoning.


14


However, common sense would


suggest that attempts to reason mathematically


would be constrained by limitations


in calculations skills. Unfortunately, a


major difficulty in identifying math learning


disabilities accurately is that, like learning


to read, learning mathematics concepts


is dependent upon the teacher’s


knowledge of the concepts and ability to


present them.


13


68 THE FUTURE OF CHILDREN – SPRING 1996


Interventions for Learning


Disabilities


Space does not permit an extended review


of research on intervention methods for


different types of learning disabilities.


However, high-quality prospective longitudinal


research methods are now being


applied to the study of treatment methods


for reading disabilities, and that research is


summarized here.


Research attempting to identify effective


treatment methods for different types and


severity levels of reading deficits has been


enormously difficult. This is because typical


treatment studies have not been able to reliably


determine whether the outcomes seen


were attributable to the treatment method,


the child’s general development, the child’s


previous instruction, the concurrent instruction


being provided in the regular classroom,


or combinations of these factors. In


addition, a majority of treatment studies


have been hampered by not having control


over teacher expertise and training. Thus, if


a treatment method does or does not work


effectively, one does not know if it is because


of the characteristics of the method, the


Learning Disabilities 69


Source: Adapted with permission from Shaywitz, S.E., Fletcher, J.M., and Shaywitz, B.A. Issues in the definition and classification


of attention deficit disorder.


Topics in Language Disorders (1994) 14:1–25.


Figure 2


Co-occurrence of Reading Disability with Attention Deficit


Disorder in a Sample of 445 Students at Ninth Grade


Study population: 445 children recruited through a random sample of those attending Connecticut public


kindergarten during the 1983–84 school year. This cohort was followed for several years. This chart


reflects measures taken during the subjects’ ninth-grade year.


a


RD is defined as either an ability-achievement discrepancy (based on a regression formula) or a reading


standard score below the 25th percentile.


b


ADD is defined as a score of greater than or equal to 1.5 above the mean on the inattention scale of the


Multigrade Inventory for Teachers.


c


RD with ADD is the percentage of all students meeting the criteria for RD in this study who also met the


criteria for ADD.


d


ADD with RD is the percentage of all students meeting the criteria for ADD in this study who also met the


criteria for RD.


RD


a ADDb


ADD


c with RD d


0


10


20


30


40


Prevalence Rate (Percent)


RD with ADD


characteristics of the teacher, or the characteristics


of the child.


Since the late 1980s, a number of welldesigned


longitudinal treatment studies


have been conducted. Because these studies


have the capability to intervene with children


early on and follow them over time,


many of the methodological problems


described above have been addressed. These


intervention studies have provided information


about how to prevent reading disabilities


as well as how to address reading disabilities


once they are detected at later ages.


For example, Blachman and her colleagues


59–


61


have shown that instruction in


phonological awareness at the kindergarten


level has significant positive effects


on reading development during the first


grade. Within this context, research has


demonstrated that proper instruction carried


out by informed teachers can prevent


reading failure both for children with


inherent LD in basic reading skills and for


children whose lack of exposure to “language


rich” environments and language


development activities during the first five


years of life places them at risk for reading


deficits. For instance, in a series of studies,


Blachman


60,61 provided 84 low-income,


inner-city children with 11 weeks of intensive


instruction, 20 minutes per day, with


one teacher instructing a small group of


four to five students in several aspects of


phonological awareness. Prior to instruction,


classroom teachers also received 14


hours of intensive training. At the end of


the 11 weeks, children receiving the interventions


significantly (p < 0.0001) outperformed


control children at reading phonetically


regular words and at related tasks.


A follow-up study conducted in February


and May of the first-grade year showed that


the gains were maintained if the first-grade


curriculum continued the same emphasis


on phonological skill development. Similar


studies of kindergarten and first-grade children


conducted by other researchers


62–64


have yielded similar results.


Unfortunately, not all children with reading


disabilities have the benefit of appropriate


early interventions. As discussed earlier,


most children whose reading disability is not


recognized until third grade or later and


who receive standard interventions fail to


show noticeable improvement. However,


intensive instruction of appropriate duration


provided by trained teachers can remediate


the deficient reading skills of many


children. For example, in one study,


Alexander and her colleagues


65 provided 65


severely dyslexic children with 65 hours of


individual instruction in addition to group


instruction in phonemic awareness and synthetic


and analytic skills. This intensive treatment


approach improved the reading skills


of the children from an initial reading score


of 77 to an average of 98.4 (mean = 100) on


a measure of alphabetic reading skills.


Longitudinal studies continue to demonstrate


the efficacy of intensive and informed


multidimensional treatment programs.


64,66


Several additional findings have emerged


from these longitudinal treatment studies.


It is clear that children with severe phonological


deficits, leading to poor decoding


and word recognition skills, respond to


treatment at slower rates than youngsters


with mild to moderate deficits.


44,67 In addition,


instruction and interventions for reading


failure, which focus primarily on context


and reading comprehension without


commensurate attention paid to phonological


awareness, decoding, and word recognition,


show limited results.


67–69 Finally, the


success of even the best-designed reading


intervention program is highly dependent


upon the training and skills of the


teacher.


22,29–31,38


Disability in basic reading skills has been


a prime candidate for treatment studies


because it is the most common form of LD,


it is the most objectively identifiable, and


more knowledge is available concerning its


causes and developmental course. Interventions


for other types of learning disabilities


have been developed but not studied as


extensively and not studied in prospective,


longitudinal research. There is as yet no


solid indication whether early, effective


interventions for disability in basic reading


70 THE FUTURE OF CHILDREN – SPRING 1996


Instruction in phonological awareness at the


kindergarten level has significant positive


effects on reading development during the


first grade.


skills will affect the developmental course of


other forms of learning disability.


Outcomes


Learning disabilities, sometimes inappropriately


conceptualized as a “mild” disorder,


may be anything but—they may be persistent


and may not respond to general instruction


or to inappropriate (for example, whole language)


instruction. Unless identified early


on and taught by expert teachers using


detailed and intensive approaches emphasizing


teaching both in phonological awareness


and phonics instruction, children who


learn poorly in the third grade can be


expected to learn poorly throughout middle-


and high-school grades. Unfortunately,


the majority of children with learning disabilities


are still not identified until the third


or fourth grade and do not receive appropriate


and timely reading instruction. In


turn, those students with learning disabilities


who graduate from high school are destined


for few postschool opportunities. The


minority of children with LD who received


appropriate early intervention have not


been identified for long-term follow-up so


their long-term outcomes are speculative,


but there is reason for optimism in their significantly


improved short-term outcomes.


At present, the long-term outcomes for


the majority of individuals with learning


disabilities who did not receive appropriate


early reading instruction are frequently


bleak. It is known from the epidemiological


data cited earlier that 75% of the children


with disabilities in reading who are not


identified until the third grade continue to


have reading disabilities in the ninth


grade.


24 In a recent review, Martin70 reported


that a considerable percentage (26.7%)


of high school students identified as having


learning disabilities drop out of


school prior to graduation. Another 16%


of students with learning disabilities exit


school for “unknown” reasons without a


diploma. Equally disturbing, Fairweather


and Shaver


71 found that only 17.1% of the


individuals with learning disabilities whom


they followed for three to five years after


high school were enrolled in any postsecondary


course, including vocational courses.


Only 6.7% of the students with learning


disabilities participated in two-year higher


education programs, and only 1.8% participated


in four-year programs.


While these data suggest that individuals


with learning disabilities do not markedly


improve their academic skills (particularly


reading skills) and face limited educational


and vocational opportunities, it should not


be concluded that individuals with LD


cannot be taught. They can, but, as stated


throughout this paper, interventions are


most likely to be successful if applied early


and carried out by expert teachers.


Conclusions


The past decade has witnessed a significant


improvement in the quality of research on


learning disabilities. Much of this recent


research has been longitudinal in nature,


thus opening the door to the identification


of better predictors of different types of


LD, their prevalence, their developmental


course, and their response to intervention.


Specifically,


n


The definitional issues addressed in this


article continue to be the single greatest


impediment to understanding learning disabilities


and how to help children and adults


with LD.


n


Maintaining the term “learning disabilities”


makes little sense for scientific purposes,


clinical purposes, or school policy purposes.


Instead, the field must grapple with the clear


need to address each type of learning disability


individually to arrive at clear definitional


statements and a coherent understanding


of etiology, developmental course,


identification, prevention, and treatment.


n


Reading disability in the form of deficits


in phonological awareness is the most prevalent


type of learning disability and affects


approximately 17% of school-age children


to some degree.


n


While other factors will, no doubt, be


identified as contributing to reading disability,


deficits in phonological awareness will


most likely be found to be the core deficit.


Learning Disabilities 71


Learning disabilities, sometimes inappropriately


conceptualized as a “mild” disorder,


may be anything but–they may be persistent


and may not respond to general instruction.


Research during the past decade has shown


that deficits in phonological awareness can


be identified in late kindergarten and first


grade using inexpensive, straightforward


testing protocols, and the presence of these


deficits is a strong indicator that reading disability


will follow.


n


Although it is now possible to identify


children who are at-risk for reading failure,


and some of the instructional conditions


that must be in place from the beginning of


formal schooling are understood, it is still


true that the majority of LD children are not


identified until the third grade. Therefore,


policy initiatives should focus on the dissemination


of existing early identification and


early intervention programs.


n


Interventions for reading disability must


consist of explicit instructional procedures


in phonological awareness, sound-symbol


relationships, and meaning and reading


comprehension, and should be provided by


expert teachers in the kindergarten and


first-grade years.


n


In general, teachers remain seriously


unprepared to address individual differences


in many academic skills but particularly


in reading. However, teachers cannot be


expected to know what they have not been


taught, and clearly colleges of education


have let students down. Regrettably, being


unprepared takes a toll on teachers. Many


teachers worry about their failures with hardto-


teach students, become frustrated, lose


confidence, and leave the profession, or discontinue


attempting to teach children with


special needs. This cycle of events calls for


honest and aggressive reform in higher education.


n


While early intervention is necessary, it


should not be assumed to be


sufficient to


address the multiple manifestations of learning


disability. Even those students who


receive appropriate phonological instruction


at a young age may require continuous


and intensive support to deal with other cooccurring


disorders.


n


When policymakers consider “inclusionary”


models of instruction, they must consider


carefully whether those models can provide


the critical elements of intensity and the


appropriate duration of instruction, along


with teacher expertise in multiple teaching


methods and in accommodating individual


learning differences.


72 THE FUTURE OF CHILDREN – SPRING 1996


1. Office of Special Education Programs.


Implementation of the Education of the Handicapped Act:


Eleventh annual report to Congress.



Washington, DC: U.S. Department of Education, 1989.


2. Lyon, G.R. Research initiatives and discoveries in learning disabilities.


Journal of Child Neurology


(1995) 10:120–26.


3. Lyon, G.R., ed.


Frames of reference for the assessment of learning disabilities: New views on measurement


issues



. Baltimore: Paul H. Brookes, 1994.


4. Lyon, G.R., and Moats, L.C. An examination of research in learning disabilities: Past practices


and future directions. In


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29. Lyon, G.R., Vaasen, M., and Toomey, F. Teachers’ perceptions of their undergraduate and


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46. Wagner, R. From simple structure to complex function: Major trends in the development of


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74 THE FUTURE OF CHILDREN – SPRING 1996


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1995) 27,2:153–85.


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of phonologically based reading disabilities. In


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acquisition: Implications for intervention research



. B.A. Blachman, ed. Mahwah, NJ: Erlbaum.


In press.


63. Torgeson, J.K., Morgan, S., and Davis, C. The effects of two types of phonological awareness


training on word learning in kindergarten children.


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84:364–70.


64. Foorman, B.R.


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Grant HD 30995. Bethesda, MD: The National Institute of Child Health and Human


Development, December 1995.


65. Alexander, A., Anderson, H., Heilman, P.C., et al. Phonological awareness training and remediation


of analytic decoding deficits in a group of severe dyslexics.


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41:193–206.


66. Torgesen, J.D.


Prevention and remediation of reading disabilities. Progress Report. NICHD Grant


HD 30988. Bethesda, MD: The National Institute of Child Health and Human Development,


December 1995.


67. Torgesen, J.K., Wagner, R.K., and Rashotte, C.A. Longitudinal studies of phonological processing


and reading.


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68. Iversen, S., and Tunmer, W.E. Phonological processing skills and the Reading Recovery


Program.


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69. Foorman, B.R. Research on the great debate: Code-oriented versus whole-language approaches


to reading instruction.


School Psychology Review (1995) 24:376–92.


70. Martin, E.W. Learning disabilities and public policy: Myths and outcomes. In


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G.R. Lyon, D.B. Gray., J.F. Kavanagh, and N.A. Krasnegor, eds. Baltimore: Paul H. Brookes,


1993, pp. 325–42.


71. Fairweather, J.S., and Shaver, D.M. Making a transition to postsecondary education and training.


Exceptional Children



(1990) 57:264–70.


Sources for Table 1 on pages 64–65:


The Yale Research Group


The principal investigator for the Yale Learning Disability Research Center is Dr. Bennett


Shaywitz, professor of pediatrics and professor and chief of pediatric neurology, the Yale


University School of Medicine, 333 Cedar Street, New Haven, CT 06510. The Yale Group also


consists of Drs. Sally Shaywitz, John Gore, Pawel Skudlarski, Robert Fulbright, Todd


Constable, Richard Bronen, and Cheryl Lacadie from Yale University; Drs. Alvin Liberman,


Learning Disabilities 75


Kenneth Pugh, Donald Shankweiler, Carol Fowler, Anne Fowler, and Leonard Katz from the


Haskins Laboratories; Drs. Jack Fletcher and Karla Steubing from the University of Texas


Medical School; Drs. David Francis and Barbara Foorman from the University of Houston;


Dr. Dorothy Aram from Emerson College; Dr. Benita Blachman from Syracuse University;


Drs. Keith Stanovich and Linda Siegel from the Ontario Institute for Studies in Education;


Dr. Rafael Kloorman from the University of Rochester; and Dr. Irwen Kirsch from the


Educational Testing Service.


The Ontario Research Group


Drs. Keith Stanovich and Linda Siegel are professors of psychology and special education at


the Ontario Institute for Studies in Education (OISE), Department of Special Education,


Toronto, Ontario, Canada M5S 1V6 Canada. They are affiliated with the Yale University


Learning Disability Research Center funded by the NICHD, as well as senior level scientists at


OISE where funding is obtained primarily through the Canadian Research Council.


The University of Colorado Research Group


The principal investigator for the University of Colorado Learning Disability Research Center is


Dr. John DeFries, professor and director of the Institute for Behavioral Genetics, the University


of Colorado, Campus Box 447, Boulder, CO 80309-0447. The Colorado research team consists


of Drs. Richard Olson, Barbara Wise, David Fulker, and Helen Forsberg from the University of


Colorado, Boulder; Dr. Bruce Pennington from the University of Denver; Drs. Shelly Smith and


William Kimberling from the Boys Town National Research Hospital in Omaha; Dr. Pauline


Filipek from the University of California, Irvine; and Drs. David Kennedy and Albert Galaburda


from Harvard University.


The Bowman Gray School of Medicine Research Group


The principal investigator for the Center for Neurobehavioral Studies of Learning Disorders is


Dr. Frank Wood, professor of neurology and neuropsychology, Bowman Gray School of


Medicine, 300 S. Hawthorne Road, Winston-Salem, NC 27103. Also from the Center are Drs.


Rebecca Felton, Cecille Naylor, Mary McFarlane, John Keyes, Mark Espeland, Dale Dagenbach,


and John Absher from the Bowman Gray School of Medicine; Dr. Raquel Gur from the


University of Pennsylvania; Dr. Connie Juel from the University of Virginia; and Dr. Jan Loney


from the State University of New York at Stoney Brook.


The Johns Hopkins Research Group


The principal investigator for the Johns Hopkins Learning Disability Research Center is Dr.


Martha Denckla, professor of neurology, pediatrics, and psychiatry, Johns Hopkins University


School of Medicine, 707 North Broadway, Suite 501, Baltimore, MD 21205. The Hopkins


research team consists of Drs. Allan Reiss, Harvey Singer, Linda Schuerholz, Lisa Freund,


Michelle Mazzocco, and Mark Reader from the Kennedy-Krieger Research Institute at Johns


Hopkins; Drs. Frank Vellutino and Donna Scanlon at the State University of New York at


Albany; Dr. Mark Appelbaum from Vanderbilt University; and Dr. Gary Chase from Georgetown


University.


The Florida State University Research Group


The principal investigator of the Florida State University Learning Disabilities Intervention


Project is Dr. Joseph Torgesen, professor of psychology, Florida State University, Tallahassee, FL


33124-2040. Members of the Florida State Research Group are Drs. Richard Wagner and Carol


Rashotte from Florida State University; Drs. Ann Alexander and Kytja Voeller from the


University of Florida, and Ms. Patricia Lindamood from Lindamood-Bell Learning Processes.


The University of Houston Research Group


The principal investigator for the University of Houston Learning Disabilities Intervention


Project is Dr. Barbara Foorman, professor of educational psychology, University of Houston,


4800 Calhoun, Houston, TX 77204. The Houston group also consists of Drs. David Francis and


Dorothy Haskell from the University of Houston; Drs. Jack Fletcher and Karla Steubing from


the University of Texas Medical School; and Drs. Bennett and Sally Shaywitz from Yale


University.


The University of Miami Research Group


The principal investigator for the University of Miami Learning Disabilities Program Project is


Dr. Herbert Lubs, professor of pediatrics and genetics, University of Miami School of Medicine,


MCCD, P.O. Box 16820, Miami, FL 33101. The Miami group also consists of Drs. Ranjan


Duara, Bonnie Levin, Bonnie Jallad, Marie-Louis Lubs, Mark Rabin, Alex Kushch, and Karen


Gross-Glenn, all from the University of Miami.


76 THE FUTURE OF CHILDREN – SPRING 1996

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القياس والتقويم (مواقع عالمية)

مواقع مفيدة للاختبارات والمقاييس

مؤسسة بيروس للاختبارات والمقاييس

https://buros.org/

مركز البحوث التربوية

http://www.ercksa.org/).

القياس والتقويم

https://www.assess.com/

مؤسسة الاختبارات التربوية

https://www.ets.org/

إحصائية الموقع

عدد الصفحات: 3687

البحوث والمحاضرات: 1166

الزيارات: 192957