No. 16; Updated December 2011
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Parents are often worried when their child has learning problems in school. There are many reasons for school failure, but a common one is a specific learning disability. Children with learning disabilities can have intelligence in the normal but the specific learning disability may make teachers and parents concerned about their general intelligence. Often, these children may try very hard to follow instructions, concentrate, and "be good" at home and in school. Yet, despite this effort, he or she is not mastering school tasks and falls behind. Learning disabilities affect at least 1 in 10 schoolchildren.
It is believed that learning disabilities are caused by a difficulty with the nervous system that affects receiving, processing, or communicating information. They may also run in families. Some children with learning disabilities are also hyperactive; unable to sit still, easily distracted, and have a short attention span.
Child and adolescent psychiatrists are aware that some of the long range consequence of learning disabilities can be lessened with early intervention. However, if not detected and treated early, they can have a "snowballing" effect. For instance, a child who does not learn addition in elementary school cannot understand algebra in high school. The child, trying very hard to learn, becomes more and more frustrated, and develops emotional problems such as low self-esteem in the face of repeated failure. Some learning disabled children misbehave in school because they would rather be seen as "bad" than "stupid."
Frequent signals of learning disabilities, that parents should watch for in their child include the following:
- difficulty understanding and following instructions.
- trouble remembering what someone just told him or her.
- fails to master reading, spelling, writing, and/or math skills, and thus fails
- difficulty distinguishing right from left; difficulty identifying words or a tendency to reverse letters, words, or numbers; (for example, confusing 25 with 52, "b" with "d," or "on" with "no").
- lacks coordination in walking, sports, or small activities such as holding a pencil or tying a shoelace.
- easily loses or misplaces homework, schoolbooks, or other items.
- difficulty understanding the concept of time; is confused by "yesterday, today, tomorrow."
Generally, an important first step is to understand the child's learning difficulties and consider how they will affect their communication, self help skill, willingness to accept discipline, impact on play, and capacity for independence. Such problems deserve a comprehensive evaluation by an expert who can assess all of the different issues affecting the child. A child and adolescent psychiatrist can help coordinate the evaluation, and work with school professionals and others to have the evaluation and educational testing done to clarify if a learning disability exists. This includes talking with the child and family, evaluating their situation, reviewing the educational testing, and consulting with the school. The child and adolescent psychiatrist will then make recommendations on appropriate school placement, the need for special help such as special educational services or speech-language therapy and help parents assist their child in maximizing his or her learning potential. Sometimes individual or family psychotherapy will be recommended. Medication may be prescribed for hyperactivity or distractibility. Parents need to consider the delicate balance between providing too much or too little assistance to their child to help them meet their educational goals. It is important to strengthen the child's self-confidence, which is vital for healthy development, and also help parents and other family members better understand and cope with the realities of living with a child with learning disabilities.
The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 8,500 child and adolescent psychiatrists who are physicians with at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry.
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