Learning Disabilities, Attention Deficit Hyperactivity Disorder, and DCD

1. Learning Disabilities, Attention Deficit Hyperactivity Disorder, and DCD Chapter 20

2. Learning Disabilities • Specific learning disabilities - IDEA • Operationalized by two criteria • IQ of 70 or higher • Severe discrepancy between intellectual ability and academic achievement in one or more areas • Diversity of profiles • IDEA defines what can and cannot be considered a learning disability

3. Common Terms • Dyslexia - severe reading disorder presumed to be of neurological origin • Aphasia - impairment of ability to communicate presumed to be of neurological origin • Dysgraphia - writing disorder • Dyscalculia - math disorder • Amnesia - memory disorder

4. Developmental Coordination Disorder (DCD) • Recognized by APA and WHO in 1987 • Activities that require motor coordination are below those expected for age and intelligence • Interferes with academic and ADL • Not caused by medical disorder or PDD • If MR, motor difficulties excessive

5. Attention Deficit Hyperactivity Disorder (ADHD) • IDEA - within the category of OHI • Persistent pattern of inattention and/or hyperactivity-impulsivity • Comorbidity - frequently coexists with anxiety, bipolar, mental illness, conduct disorders, depression, DCD, LD and oppositional defiant disorders

6. Prevalence of Learning Disabilities • 50% of children in special education • 50 - 80% also have ADHD • Young children identified ‘with developmental disabilities’ or ‘at risk for developmental disabilities’ • More boys than girls - sociocultural

7. Etiology of LD • Biological rather than environmental • Motor problems associated with cerebellar-vestibular • Subtypes • Language impaired with subtle motor difficulties, mainly in information processing • Visual-spatial-motor impaired with obvious perceptual-motor problems and clumsiness

8. Historical Perspectives • Special Education • Used perceptual- motor training to remediate language and learning problems • Denounced in the 1980s • Principles for managing the learning environment are still essential

9. Historical Perspectives • Physical Education • Used perceptual-motor training to remediate clumsiness and improve self-control and self-concept • Academic abilities can only be enhanced by movement if games teach specific academic skills • Brain research supports using movement to improve mental functioning

10. Assessment for Identifying DCD • Need for valid techniques and agreement on identifying criteria • One instrument for identification of interference with activities of daily living

11. Specific Problems Applicable to LD and DCD • Immature body image and agnosias • Poor spatial orientation • Overflow movements • Dissociation and figure-background • Motor planning and sequencing • Temporal organization, rhythm, and force • Other executive functions

12. Immature Body Image and Agnosias • Finger agnosia - impaired perceptual awareness • Inability to identify body parts and surfaces • Inability to translate knowledge of right and left into following instructions • Difficulty in making judgments about body size, shape, and proportions • Activities to enhance body image

13. Poor Spatial Orientation • Difficulty estimating distance, height, width, and other coordinates of space • Commonly bump into things • Misjudging space requirements needed to go under, over, or through obstacles • Activities to enhance spatial orientation

14. Overflow Movements • Greater levels of overflow - inability to keep opposite limbs motionless when performing one-arm, one-leg tasks • Commonly perceived as clumsiness • Linked to disinhibition - generalized disorder of inhibitory control

15. Dissociation and Figure-Background • Dissociation - problems in organizing and perceiving parts into wholes • Activities to enhance dissociation • Figure-background constancy - ability to pick one object, or figure, out of a complex background • Activities to enhance figure-background constancy

16. Motor Planning and Sequencing • Executive functions that include thoughts and actions in relation to: • Initiating movement • Terminating movement • Putting parts in correct order • Activities to enhance motor planning and sequencing

17. Temporal Organization, Rhythm and Force • Some children with LD can organize parts into wholes and exercise proper sequencing, but cannot cope with rhythm • Timing is especially important when accuracy, speed, and force are involved • Activities to enhance temporal organization, rhythm, and force

18. Other Executive Functions • Difficulty in performance of skills • Learn best from trial and error instead of demonstration or listening to instruction • Difficulty properly encoding visual and auditory input to memory • Difficulty in visualization of skills • Learn best with one modality

19. Activity Deficit Phenomenon • Avoidance strategies lead to sedentary lifestyle • Helps to preserve self-esteem related to movement • Early intervention is essential • Motivation to stay physically active

20. Spontaneous Instructional Strategies • Metacognitive strategy instruction • Modality-based instruction • Cognitive style matching • Self-talk and verbal rehearsal • Motivation and self-concept enhancement

21. Metacognitive Strategy Instruction • Personal knowledge about the ways we think, move, and learn • Effective in improving academic skills in persons with LD and offers promise in motor learning • Balance traditional explicit learning and movement exploration

22. Modality-Based Instruction • Most people are mixed modality learners • Traditional physical education presents instruction in both visual and auditory formats • Persons with LD may have visual preference or auditory preference

23. Cognitive Style Matching • Individual’s approach to analyzing and responding to stimuli • Student and teacher match - few problems • Field-dependent - strongly influenced by the visual field, see wholes and have difficulty with details, spend little time planning and need external structure - field-independent is the opposite

24. Self-Talk and Verbal Rehearsal • Used successfully to assist children learning motor sequences, improving game performance, and controlling impulsivity • Self-talk - talking oneself through an activity or sequence - simultaneous • Verbal rehearsal - saying aloud the parts of a planned movement before execution

25. Motivation and Self-Concept Enhancement • Lower self-concepts and more external locus of control • Utilize games that emphasize cooperation rather than competition, and success-oriented movement experiences along with individual/small group counseling

26. Fitness and Leisure Concerns • Assistance in finding successful lifetime physical activities • Engagement in solitary play • Leisure activities tend to be passive with feelings of loneliness • Activities should emphasize cooperative teamwork and sportsmanship • Leisure education and counseling

27. Attention Deficit Hyperactivity Disorder (ADHD) • Combination of inattention and/or hyperactive-impulsive symptoms that are present in at least two settings that interfere with academic, social, and occupational functioning • Often seen in conjunction with LD • Three subtypes

28. Etiology and Prevalence • Unclear and controversial • Causative factors • Interactive genetic • Neurological • Psychosocial • 3 to 7% of school-age population • More frequent in males • Frequent comorbid condition

29. Inattention • Selective attention - ability to pick up and attend to the central or desired stimulus • Concentration - ability to sustain attention • Narrow focusing - ability to narrow attention to a particular task • Broad focusing - ability to effectively attend to many stimuli at one time

30. Inattention • Often measured by time-on-task • Variables affecting attention • Age • Degree of difficulty • Number and intensity of distractors • Novelty and/or interest of activity • Changes in weather and humidity • Stimuli overload is a particular problem

31. Impulsivity or Disinhibition • Errors of commission • Tendency to move without carefully considering alternatives • Associated with field dependence - tries to please significant others • Exercise catastrophic reactions (screaming, aggression, sobbing uncontrollably) to unexpected stimuli

32. Hyperactivity • Disorders of thinking, listening, reading, writing, spelling, or arithmetic exist due to the inability to sit still long enough to complete a task • Older children may be able to consciously slow down the pace • May be related to impulse control

33. Other Behavioral Problems • Social perception inadequacies • Perseveration • Misunderstandings that stem from deficits in listening, thinking, and speaking skills

34. Social Perception Inadequacies • Inability to recognize the meaning and significance of the behavior of others • Often occurs with LD and ADHD • Difficulty in making and keeping friends • Need for structured play • Degree of freedom progresses

35. Perseveration • Inability to shift easily from one idea or activity to another • Often interpreted as stubbornness • Opposite of distractibility and contributes to behavioral rigidity • Activities for intervention

36. Principles for Managing Environment • Structure - establishing a routine that is repeated day after day and leaves nothing to chance • Space reduction - utilize lane markers and partitions to delimit the expanse of play area and diligently enforce boundary infractions

37. Principles for Managing Environment • Extraneous stimuli control - maintain a neat, clean, and well-ordered play area and limit any extraneous stimuli • Instructional stimulus enhancement - extensive and concentrated use of color to focus and hold student’s attention

38. Modifying Physical Education Content • Different content than traditional • Focus on: • Learning relaxation techniques • Learning impulse control • Encourage reflectivity and attention to detail in sport, dance, and aquatic activities

39. Medication • Medication used as a last resort • Stimulants used to slow the child down, increase attention span, and help with concentration • Side effects may include depressed appetite and sleeplessness • May also affect balance and coordination