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Use of the Jordan Left-Right Reversal Test with learning disabled children.

This investigation established the reliability of the Jordan Left-Right Reversal Test for learning disabled children. Test-retest reliability coefficients ranged from .89 to .92 for a sample of 91 children, 5 through 12 yr., attending private schools for children with learning disabilities. Reversal errors decreased with age for boys and girls, although girls 9 through 12 made significantly fewer errors than did boys in the same age range. Learning disabled children made more errors at all ages than normal children. This test instrument was determined to be a measure of the global tendency to make visual reversal errors and was viewed as an appropriate part of the learning disabilities diagnostic procedure.

Age Factors↗

Photoscreening for refractive errors in children and young adults with severe learning disabilities using the MTI photoscreener.

PURPOSE: To test the potential ability of the MTI photoscreener to facilitate screening for significant refractive errors in children and young adults with severe learning disabilities. METHODS: Thirty-eight patients with severe learning disabilities from a special school were examined with the photoscreener, and underwent cycloplegic refraction, an ophthalmological and an orthoptic examination. The age at examination, the cause of learning disability, the pupil size, the number of photographs required for accurate interpretation, the co-operation of the subject and the presence or absence of strabismus were recorded. An educational psychologist had performed a psychological assessment on all the children. The results of the cycloplegic retinoscopy were compared with the photorefraction results. RESULTS: A photorefraction was possible in 37 patients and cycloplegic refraction in all the patients. The patients had severe learning difficulties with an intelligence quotient of less than 50. All the patients had behavioural problems, 9 patients had associated cerebral palsy, 8 had chronic epilepsy, 1 patient was brain damaged from a non-accidental injury and 1 from a road traffic accident. The mean age of the patients was 10.0 +/- 4.9 years (range 3-18 years), the average pupil diameter during photoscreening was 6.1 +/- 0.9 mm (range 4-8 mm) and the average number of photographs required for each subject was 2.1 +/- 0.9 (range 1-4). The photoscreener detected 10 patients with a manifest strabismus. There was one false positive and one false negative result giving a sensitivity of 92.8% and a specificity of 90%. CONCLUSION: The examination of children with severe learning disabilities for refractive errors can be extremely difficult. The MTI photoscreener is an effective means of screening such children and young adults for refractive errors and strabismus so that the children with these abnormalities may be targeted for a more detailed evaluation.

Adolescent↗

Behavioral problems and the effects of early intervention on eight-year-old children with learning disabilities.

OBJECTIVES: 1) To investigate the comorbidity of verbal and nonverbal learning disability subtypes with several domains of behavior problems among 8-year-old children. 2) To determine whether receipt of an early intervention modified the association between childhood behavior problems and learning disabilities (LD). METHODS: This is a secondary data analysis of the Infant Health and Development Program (IHDP), a randomized clinical trial of an early intervention provided between ages 0 and 3 involving 985 children born low birthweight and premature. The findings are based on a prospective follow-up of these children at 8 years of age. RESULTS: Compared to children without verbal LD (VLD), those with VLD were twice as likely to exhibit clinical levels of total behavior problems and 89% more likely to exhibit externalizing behavior problems. Analysis of specific subscales of behavior revealed significant associations with anxious/depressed and withdrawn behaviors, as well as an increased likelihood of attention problems among children with VLD. No significant association was found between nonverbal LD (NVLD) and any type of behavior problem. Furthermore, there was a significant interaction between VLD and the intervention, in which the odds of internalizing behavior problems were greater among children with VLD. No interaction effect of the intervention occurred for any type of behavior problem among children with NVLD. CONCLUSIONS: These findings provide evidence that distinct differences exist for different learning disability subtypes with regards to behavioral outcomes and the effects of early intervention services among 8-year-old children.

Child↗

Communication deviances: a comparison between parents of learning-disabled and normally achieving students.

This study explored the relationship between parents' communication deviances and children's placement in a learning disability class. Participants were the parents of 30 learning-disabled students and 30 average students attending junior high school. Samples of communication were taken from parents' participation in an experimental task. Using a "blind" sorting procedure, raters were able to identify 87% of the learning-disabled students' parents by their high communication deviance scores and 77% of the average students' parents by their low communication deviance scores on the experimental communication task (p less than or equal to .0001). Implications for future research on the etiology and remediation of learning disabilities are discussed.

Adolescent↗

PIC profiles for learning-disabled and behavior-disordered children.

Compared the performance of learning-disabled and behavior-disordered children (N = 60) on the recently published Personality Inventory of Children (PIC) to investigate the discriminant validity of the instrument. The data were analyzed by profile analysis and stepwise discriminant analysis. Results showed that learning-disabled and behavior-disordered children could be differentiated clearly on subtests that comprise the Cognitive Development and Conduct Disorder factors. However, less differentiation was found on the Internalization factor. Further examination indicated a possible diagnosis X scale "interaction" within the Internalization factor. Those learning-disabled children who also experienced "internal" difficulties tended to score high on the Somatic Concern Scale, while behavior-disordered children typically scored high on the other Internalization scales (i.e., Anxiety, Withdrawal, etc.). A total of seven of the PIC clinical and validity scales were selected in the discriminant function that separated the two groups.

Child↗

Mother-child interaction: a comparison of hyperactive, learning disabled, and normal boys.

Groups of thirteen hyperactive, learning disabled, and normal boys were observed interacting with their mothers in a structured problem-solving situation. Mothers of hyperactive boys showed a higher level of involement in task solution, and reported more behavior problems, than did mothers in comparison groups. Likewise, hyperactive boys interacted more than learning disabled or control boys.

Child↗

Relationships among self-concept and school achievement, maternal self-esteem and sensory integration abilities for learning disabled children, ages 7 to 12 years.

52 learning disabled students were assessed to evaluate the relationships among self-concept and (a) school achievement, (b) maternal self-esteem, and (c) sensory integration abilities. Of these variables, perceptual motor abilities as measured by the Southern California Sensory Integration Tests contributed to reported self-concept of learning disabled students.

Achievement↗

The sociopsychometrics of learning disabilities.

The Boston University (BU) case illustrates how the psychometrics of ability differences interact with the concept of learning disability and with the sociopolitics of schooling and society. It also illustrates that learning disabilities advocacy will not be on a sound footing as long as the field refuses to rid itself of its IQ fetishism, refuses to jettison its fixation on aptitude-achievement discrepancy, and fails to free clinical practice from the pseudoscientific neurology that plagued the field in the 1970s. A more inclusive definition of learning disability--one that abandons discrepancy notions--and a more self-critical attitude toward its own claims would advance the field of learning disabilities and help to rid it of distractions such as the BU case.

Aptitude Tests↗

Minor malformations, hyperactivity, and learning disabilities.

Standardized minor malformation scores have been reported to predict and identify children with attentional problems and hyperactivity. The reason why this marker works for only a subset of children with attention deficit hyperactivity disorder remains unclear. The dysmorphology scores on all children presenting for a multidisciplinary team evaluation of developmental disorders were examined for diagnostic correlations after children with chromosomal disorders and recognized dysmorphic syndromes were excluded. For 1233 subjects, the mean minor malformation score was 2.94 (SD = 2.05). A significant association between minor malformation scores and IQ (mean = 80.95, SD = 23.67) was accounted for by the group with IQs greater than 100 exhibiting the higher dysmorphology scores. An analysis of variance revealed no significant association between minor malformation scores and hyperactivity or attention deficit disorder. Indeed, the presence of an attention deficit disorder yielded lower mean dysmorphology scores. When the minor malformation scores were compared for those subgroups of children with and without specific learning disabilities, the learning-disabled subjects had significantly higher dysmorphology scores. Minor dysmorphic features do not relate to the presence or absence of attentional problems or hyperactivity in referred children. Rather they appear to characterize that subpopulation of children with attention deficit disorder and learning disabilities as well as a group of learning-disabled children without attentional disorders.

Adolescent↗

Better health care for people with learning disabilities.

Health care and health promotion are both integral parts of the health service of the 1990s. People with learning disabilities should have access to the same health services as all other members of society. Their specific needs should not prevent them from such access; rather, services should be provided that facilitate their participation. This paper highlights some factors that have prevented people with learning disabilities from having appropriate access to health-care and health promotion services. It also outlines the components which will help to redress the balance, including practical ways to encourage active participation and the development of appropriate learning strategies for people with learning disabilities. Also discussed is the role of the community nurse as a provider of services for people with learning disabilities. Also discussed is the role of the community nurse as a provider of services for people with learning disabilities.

Community Health Nursing↗

DOes the child with a learning disability have a biochemical defect?

SInce the brains of children with learning disabilities are not available for direct study, neurobiochemical explanations for the characteristic features exhibited by these children must necessarily be hypothetical. There is considerable evidence to show that the catecholamines, noradrenaline and dopamine, play a major role in the function of areas of the brain which mediate mood, emotional response and state of arousal. Physiological evidence of underarousal in some learning-disabled children and the dramatic effect of stimulant medication suggest that there may be a fundamental defect in catecholamine metabolism. Support for this hypothesis is provided by certain pathological studies and comparative neurochemical studies, while familial clustering of cases suggests an underlying genetic mechanism to account for the biochemical defect. However, learning-disabled children are a heterogeneous group and the postulated neurobiochemical model must be regarded merely as heuristic, for it does not have universal application.

Animals↗

Spirituality and learning disabilities: a qualitative study.

This article describes a unique empirical study where critical incidents were obtained from learning disability nurses to understand how they attempt to meet the spiritual needs of the people for whom they care. Following analysis, the nurses' approaches to meeting spiritual needs were categorized as 'personal' and 'procedural', and each of these is described in turn. There then follows a discussion on the effects of these nurses' interventions on both clients and their families, and nurses themselves. The findings of the study illuminate how these learning disability nurses attempted to meet the spiritual needs of people with learning disabilities in their care. The findings may help nurses ensure that spiritual needs are identified in the construction of the personal care plans of people with learning disabilities.

Humans↗

Development of reciprocal hemispheric inhibition in normal and learning-disabled children.

Matched populations (N = 90) of learning-disabled and normal children representing an age range of approximately five years were administered a dichotic listening task to examine the hypothesized development of reciprocal control by the left cerebral hemisphere over the right. An analysis of the free-recall raw scores for each ear by the two groups of children at three developmental levels supported the notion that age-related changes occur in the right cerebral hemisphere and not in the left. Consequently, the notion that the left hemisphere becomes more lateralized during development was not supported. Rather, a differential model of cerebral inattention and suppression of stimuli perceived transcallosally by the left hemisphere was adopted as more appropriate in conceptualizing neuropsychological accomodation and functioning in learning-disabled children.

Child↗

Emergency care for people with learning disabilities: what all nurses and midwives need to know.

People with learning disabilities have high health needs and as a result will require access to all aspects of healthcare systems, including the emergency services. The evidence of the health needs experienced by this group is evolving and developing and they have a range of issues that will bring them into contact with general hospital and the emergency services. It is now apparent that they experience risks to their health when accessing general hospital care and action is required to identify and address their distinct health needs. Emergency services are often the first point of entry into the healthcare system and as a result they need to develop their knowledge and skills in meeting the health needs of this group. Partnership working with specialists in learning disability health and emergency care can help to improve care.

Clinical Competence↗

Visual-ocular control of normal and learning-disabled children.

Much of the data typically presented to support the vestibular dysfunction hypothesis among learning-disabled children is based on a measure of vestibular function that is confounded by visual input. Thus these data may provide evidence of deficits in visual-ocular function in this population. To explore this possibility the authors investigated the differences in visual-ocular function, in particular optokinetic nystagmus (OKN), between normal and learning-disabled children. Children were tested for refixation saccades, smooth ocular pursuit, spontaneous nystagmus, gaze nystagmus and OKN. The testers were blind to the group to which the children belonged. No significant differences were found between the groups on any of the variables. It is concluded that there is no difference in nystagmic behaviour between normal and learning-disabled children, and that the differences in eye movements reported among learning-disabled children should not be attributed to the visual-ocular control functions investigated here.

Child↗

Learning disabilities in children with congenital adrenal hyperplasia.

Early exposure to androgens may be a cause of the higher incidence of learning disabilities among males. To test this hypothesis, we determined the frequency of learning disabilities, as measured by extent of Wechsler Verbal-Performance IQ discrepancy, among female patients with congenital adrenal hyperplasia, who are exposed in utero to excess androgens for their sex. A significantly larger Verbal-Performance IQ discrepancy (10.1 vs 7.7) was found for the 18 female patients than for 27 unaffected female siblings (P = .045, one-tailed). The Verbal-Performance IQ discrepancy of the females with congenital adrenal hyperplasia is in the male range (10.4 to 13.4), similar to males with congenital adrenal hyperplasia (n = 20) and unaffected male siblings (n = 31). In addition to the sex effect, there is an effect of the type of congenital adrenal hyperplasia on the frequency of learning disabilities. Simple virilizers are more likely to be learning disabled than salt-wasters (P = .04, one-tailed). However, salt-waster patients have a lower IQ (104 vs 117) than simple virilizer patients (P = .005, one-tailed). Presumably, this is because some salt-waster patients suffer brain injury from episodes of hypotension and hyponatremia. The diffuse insult to the central nervous system may overide the androgen effect and result in a general cognitive impairment. Because of this confounding effect on IQ in the salt-waster form of congenital adrenal hyperplasia, the simple virilizer female versus unaffected female siblings reprsents the best test of the hypothesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Sexual abuse of adults with learning disabilities.

This paper reports a clinical study of reported or disclosed sexual abuse of adults with learning disabilities. The findings support the results of a recent survey [V. Turk & H. Brown (1993) Sexual abuse of adults with learning disabilities: results of a two-year incidence survey. Mental Handicap Research 6, 193-216] but some differences were found, particularly with regard to sex of the survivors. The study also illustrates more than previous studies a link between sexual abuse and sexualized and inappropriate sexual behaviour and other challenging behaviours in men with learning disabilities.

Adolescent↗

The social construction of ability and disability: I. Profile types of Latino children identified as language learning disabled.

During the course of an ethnographic study of a bilingual special education classroom, three profile types of students emerged, ranging from students with severe language learning disabilities to students with normal abilities. The study points out the inadequacy of a medical model view of student abilities and disabilities--a view that underestimates the communicative and academic competence of bilingual students. Concurrently, the results support a contextual performance view--a view that acknowledges the role of instructional context in revealing the upper or lower range of students' communicative and academic competence. The study further suggests some contextual features of instruction that are associated with students from all profile types showing their best in terms of language and literacy skills.

Aptitude↗