CO-MORBIDITY Learning, Disabilities, ADHD, Behavioral Emotional Disorders

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CO-MORBIDITYLearning, Disabilities, ADHD,
Behavioral Emotional Disorders
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Disorders of Behavior- Arriving at a Definition

• Normal versus Disordered Behavior
• A social construct
• What constitutes good mental health?
• Concerns of frequency, intensity, duration
• Difficult periods of childhood vs. behavior
  disorder
• Lack of social skills vs. behavior disorder
• Operationalizing such terms as pervasive, normal,
• inappropriate, etc.
• Student's emotionalproblems vs. ability to
  learn. Males- in the past- propensity to rules
  breaking
• Behavior vs. Race and cultural bias
• Girls- internalize emotional disturbance.
• Other classifications

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Physiological Birth defect TBI Tourettes
Syndrome Fetal Alcohol Syndrome,
Depression Chemical and mood disorders.
Environmental Learned behaviors Mental
illness, etc. PTSS
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• Learning Disabled Students
• interact awkwardly.
• interact inappropriately in social situations.
• socially imperceptive.

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ATTENTION DEFICIT HYPERACTIVE DISORDER

• tend to react to others aggressively
• are generally rejected by peers
• lose the opportunity to learn social skills
• are isolated from most social situations
• (Westby, Cutler, 1994).
• victims of parents who are abusive or lacking
  effective parenting skills.
• (Parker, Asher 1987).

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Learning DisabilitiesTypically a Disruptionin
Maturational Delay

• Language skills
• Motor skills
• Uneven performance on IQ assessment
• Visual-Motor
• Incomplete or mixed dominance
• Social Immaturity
• Genetics

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At Risk for LD

• Established risk
• identified through a medical diagnosis
• failure to develop, thrive delay in language
  development. Unknown etiology is the important
  term.
• Biological risk
• early medical and health history indicates
  increased probability for later atypical
  development.
• (HIV, premature, injury at birth (anoxia,
  chemical dependency at birth.)
• Environmental risk
• biologically sound
• early life experience are characterized by a
  profound lack of stimulation- critical in the
  years birth to age five. Lack of cognitive
  stimulation in the formative years lack of
  nutrition, age of mother, lack of prenatal and
  neonatal care.
• Child can be at risk for all three, one or two.

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Children with LD and Behavior Disorders

• Short Attention Span
• Low Frustration Tolerance
• Insatiability- need a significant level of
  intensity, often bored, need new and novel
  activities, chronically restless, incredibly
  future oriented
• Distractibility
• Low self esteem

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Continued

• Learned helplessness
• Hyperactivity
• Sequencing deficits
• Memory deficits
• Interrogoration
• Disinhibition
• Impulsivity

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Common Elements in the DefinitionCommon Elements
in the Definitions

• Central Nervous System Dysfunction
• Uneven Growth Pattern /Psychological Processing
  Deficits
• Discrepancy Between Potential and Achievement
• Exclusion of Other Causes

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Symptoms of ADD/ADHD

• Severity
• Symptoms more frequent and severe than other
  children
• Early onset
• Symptoms must have appeared before age seven
• Duration
• Symptoms persist for at least 6 months

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Subtypes of ADHD in DSM-IV

• Primarily inattentive
• Primarily
• hyperactive and impulsive
• Combined

• ADHD-IA
• ADHD-HI
• ADHD-C

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Implications of the Law

• Children with ADD/ADHD may be eligible for
  special education services under the category of
  other health impaired
• Children with ADD/ADHD may receive services under
  the legislation of Section 504 of the
  Rehabilitation Act of 1973
• ADD/ADHD is listed as a specific condition under
  other health impaired

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Increase in Disorders
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Psychostimulant Medications for ADD/ADHD

• Ritalin
• Dexedrine
• Cylert
• Adderall
• Concerta

• 3-5 hours
• 3-5 hours
• Long-lasting
• 8 hours
• 8-12

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Precursors of Learning Disabilities-Difficulties
in any of the following

• Communication/oral language
• Phonological awareness
• Rapid naming skills
• Knowledge of the alphabet
• Visual-motor skills
• Fine- and gross-motor skills
• Attending abilities
• Social skills

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Age Span of Learning Disabilities Population

• Preschool children
• Elementary-age children
• Secondary students
• Adults

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Ages that Children with LD Are Identified
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Composition of Students with Disabilities
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Left-Right Brain Processing

• Left Brain Right Brain
• Analytical Synthesizes
• Verbal Strengths Visual (spatial imagery
• Linear Simultaneous
• Sequential Holistic
• Sees parts, pieces Sees whole, gestalt
• Precise accurate Makes sense of all the parts
• Detail oriented Interpretation of non
  verbal cues
• Step by step learner Organization
• Ambiguity
• Open ended questions

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Nonverbal Learning Disabilities

• Characteristics
• Poor social perception
• High verbal intelligence
• Early reading achievement
• More evident in adolescents and adults
• Different than academic, language and cognitive
  disabilities
• Aspergers (?)Syndrome
• Video

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Indicators of Social Disabilities

• Poor social perception
• Lack of judgment
• Lack of sensitivity to others
• Difficulty making friends
• Problems with family relations
• Social problems in school
• Undiagnosed Syndromes

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Verbal Linguistic Learning Disabilities

• Difficulties in Reading
• Students may
• Have difficulty with one or more subject areas.
• Have limited mastery of concepts.
• Have limited fund of information.
• Have limited expressive and receptive vocabulary.
• Display limited knowledge of word
• meanings.
• Do not understand special multiple meanings of
  words.
• Read significantly below level of text.

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• Content Area Reading
• Technical Vocabulary- in the content areas
  carries the conceptual load.
• Students may
• Have difficulty with one or more subject areas.
• Have limited mastery of area concepts.
• Do not understand technical words.
• Do not understand special uses of non
• technical words.
• Display limited knowledge of word
• meanings.
• Read significantly below level of text.

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• Causes
• Weak listening speaking and sight vocabulary.
• Weak contextual analysis skills.
• Inability to apply same word in different
  contexts.

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Dyslexia and the Brain
Wernicke's area Receptive language. Posterior
reading system.
Broca's area Expressive language

• There are three neural pathways for reading
• the parietal-temporal and frontal-(slower,
  analytical, used by beginning readers)
• the occipital-temporal (word form, experienced
  readers).

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Recent Brain ResearchSally Shaywitz, MD

• At left, non-impaired readers activate neural
  systems that are mostly in the back of the left
  side of the brain (shaded areas) at right,
  dyslexic readers under activate these reading
  systems in the back of the brain and tend to over
  activate frontal areas.
• In addition to their greater reliance on Broca's
  area, dyslexics are also using other auxiliary
  systems for reading, ones located on the right
  side as well as in the front of the brain.
• This is evidenced by the activation of right
  hemisphere parts of the brain. (Dyslexics and
  slow readers often sub-vocalize. The physical
  aspect to their reading is an attempt to
  compensate for the disruption in the back of the
  brain.)

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An Information-Processing Model of Learning
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Difficulties in Mathematics

• Sense of Body Image
• Visual-motor Visual Perceptual Abilities
• Spatial Relations
• Memory Abilities

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Progressing from Concrete to Abstract

• Concrete Level- Use Real Objects
• Representational Level- Use Graphic Symbols
• Abstract Level- Use Numbers

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Information Processing Problems in Mathematics

• Attention
• Visual-spatial Processing
• Auditory Processing
• Memory Retrieval
• Motor Problems
• Non Verbal LD