LEARNING
DISORDERS

▪ A learning disorder
is an information-processing
problem that prevents a
person from learning a skill
and using it effectively.
Learning disorders generally
effect people of average or
above average intelligence,
and academic
performance.
WHAT IS
LEARNING
DISORDERS ?

FIVE COMMON LDs
INCLUDE :
✔Dyslexia
✔Dyscalculia
✔Dysgraphia
✔Visual processing Disorder &
✔Non verbal Learning Disorder

DYSLEXIA
◆ A specific learning
disability that affects
reading and related
language - based
processing skills
DYSCALCULIA
◆ A specific learning
disability that affects a
person's ability to
understand numbers
and learn math facts
DYSGRAPHIA
◆ A specific learning
disability that affects a
person's handwriting
ability and fine motor
skills.

VISUAL PROCESSING
DISORDER
◆ Learning disabilities that
affect an individual's
understanding of what
they read or of spoken
language. The ability to
express one's self with oral
language may also be
impacted
NONVERBAL LEARNING
DISORDER
◆ Has trouble interpreting
nonverbal cues like
facial expressions or
body language and
may have poor
coordination

TYPES AND
CLASSIFICATIONS :
● READING
Learning disorders in reading are usually based on difficulty percieving a spoken
word as a combination of distinct sound. This can make it hard to understand how a
letter or letters represent a sound and how letter combinations make a word.
Problems with working memory - the ability to hold and manipulate information
in the moment - also can play a role.
Even when basic reading skills are mastered, children may have difficulty with the
following skills:
■ Reading at a typical pace
■ Understanding what they read
■ Recalling accurately what they read
■ Making inferences based on their reading
■ Spelling
A learning disorder in reading is usually called dyslexia, but some specialists may use
the term to describe only some of the information-processing problems that can cause

● WRITTEN EXPRESSION
Writing requires complex visual, motor and
information-processing skills. A learning disorder
in written expression may cause the following:
■ Slow and labor - intensive handwriting
■ Handwriting that's hard to read
■ Difficulty putting thoughts into writing
■ Written text that's poorly organized or hard to
understand
■ Trouble with spelling, grammar and

● MATH
A learning disorder in math may caused problems
with the following skills:
■ Understanding how numbers work and relate to
each other
■ Calculating math problems
■ Memorizing basic calculations
■ Using math symbols
■ Understanding word problems
■ Organizing and recording information while
solving a math problems

• NONVERBAL SKILLS
A child with a learning disorder in nonverbal skills appears to develop
good basic language skills and strong rote memorization skills early in
childhood. Difficulties are present in visual - spatial skills, visula -
motor skills , and other skills necessary in social or academic
functioning.
A child with a learning disorder in nonverbal skills may have trouble
with the following skills:
■ Interpreting facial expressions and nonverbal cues in social
interaction
■ Using language appropriately in social situations
■ Physical coordination
■ Fine motor skills, such as writing
■ Attention, planning and organizing

•RISK FACTORS•
▪ Family history and genetics. A family history of learning disorders increases the
risk of a child developing a disorder.
▪ Prenatal and neonatal risks. Poor growth in the uterus (severe intrauterine
growth restriction), exposure to alcohol or drugs before being born, premature
birth, and very low birth weight have been linked with learning disorders.
▪ Psychological trauma. Psychological trauma or abuse in early childhood may
affect brain development and increase the risk of learning disorders.
▪ Physical trauma. Head injuries or nervous system infections might play a role in
the development of learning disorders.
▪ Environmental exposure. Exposure to high levels of toxins, such as lead, has been
linked to an increased risk of learning disorders.

ETIOLOGY OF LEARNING
DISORDER :
• There are likely to be different causes but in
most cases, the cause (Etiology) of a child’s
learning disorder is unknown.
❑Four suspected causal factors are:
✔Brain damage
✔Heredity
✔Biochemical imbalance
✔Environmental causes

▪ Brain Damage or Dysfunction :
⮚ Some professionals believe that all children with
learning disorders suffer from some type of brain
injury or dysfunction of the central nervous system.
⮚ Learning disorders are presumed to be due to central
nervous system dysfunction.
⮚ The actual structure of the brain of some children with
reading disabilities is slightly different from that of
children without disabilities.

▪ Heredity :
⮚Individuals with certain genetic syndromes may
have an increased risk of manifesting a particular
type of learning disorders
Research into these syndromes has revealed that
girls with turner syndromes and fragile X syndrome
and boys with Kline filter syndrome tend to have
visual-perceptual learning disabilities.
⮚There is growing evidence that genetics may account
for at least some family links with dyslexia.

▪ Biochemical Imbalance :
⮚ Biochemical disturbances within a child’s body may also be a
cause of learning disabilities.
⮚ It is also suggested that learning disorders can be caused by the
inability of a child’s bloodstream to synthesize a normal amount
of vitamins.
⮚ Today, most professionals in learning disorders give little
credence to biochemical imbalance as a significant cause of
children’s learning problems .

▪ Environmental Factors :
⮚ Impoverished living conditions early in a child’s life can
contribute to LDs (Malnutrition).
⮚ Another environmental variable that is likely to contribute to
children’s learning problems is the quality of instruction they
receive.
⮚ Infants and toddlers who received infrequent communication
exchanges with their parents were more likely to show deficits in
vocabulary, language use, and intellectual development before
entering school.

WARNING SIGNS :
● Dyslexia
People with dyslexia usually have trouble making the connection between letters and
sound and with spelling and recognizing words.
People with dyslexia often show other signs of the condition. These may include :
✔ Having a hard time understanding what others are saying
✔ Difficulty organizing written and spoken language
✔ Delay in being able to speak
✔ Difficulty expressing thoughts or feelings
✔ Difficulty learning new words (vocabulary), either while reading or hearing
✔ Trouble learning foreign languages
✔ Difficulty learning songs and rhymes

✔ Slow rate of reading, both silently and out loud
✔ Giving up on longer reading task
✔ Difficulty understanding question and following
directions
✔ Poor spelling.
✔ Problems remembering numbers and sequence
(for example, telephone and addresses)
✔ Trouble telling left from right

● Dysgraphia
A child who has trouble writing or has very poor handwriting and does
not outgrow it may have dysgraphia. This disorder may cause a child
to be tense and twist awkwardly when holding a pen or pencil.
Other sign of this condition may include :
✔ A strong dislike of writing and/or drawing
✔ Problems with grammar
✔ Trouble writing down ideas
✔ Losing energy or interest as soon as they start writing
✔ Trouble writing down thoughts in a logical sequence
✔ Saying words out loud while writing
✔ Leaving words unfinished or omitting them when writing
sentence

• Dyscalculia
Sign of this disability include problems understanding basic arithmetic concepts,
such as fractions ,number lines, and positive and negative numbers
Other symptoms may include :
✔ Difficulty with math- related word problems
✔ Trouble making change in cash transactions
✔ Messiness in putting math problems on paper
✔ Trouble with logical sequences(for example, steps in math problems)
✔ Trouble understanding the time sequence of events
✔ Trouble describing math processes

Common signs that a person may have learning
disabilities include the following :
• Problems reading and/or writing
• Problems with math
• Poor memory
• Problems paying attention
• Trouble following directions
• Clumsiness
• Trouble telling time
• Problems staying organized

A child with a learning disability also may have one or more of the
following :
• Acting without really thinking about possible outcomes
(impulsiveness)
• “Acting out” in school or social situations
• Difficulty staying focused; being easily distracted
• Difficulty saying a word correctly out loud or expressing
thoughts
• Problems with school performance from week to week or day to
day
• Speaking like a younger child; using short, simple phrases; or
leaving out words in sentences
• Having a hard time listening

MANISFESTIONS :
Your child might have a learning disorder if he or she:
• Doesn't master skills in reading, spelling, writing or math at
or near expected age and grade levels
• Has difficulty understanding and following instructions
• Has trouble remembering what someone just told him or her
• Lacks coordination in walking, sports or skills such as
holding a pencil
• Easily loses or misplaces homework, schoolbooks or other
items
• Has difficulty understanding the concept of time
• Resists doing homework or activities that involve reading,
writing or math, or consistently can't complete homework
assignments without significant help

MEDICAL MANAGEMENT :
■ Extra help. A reading specialist, math tutor or other trained professional can teach
your child techniques to improve his or her academic, organizational and study skills
■ Individualized education program (IEP). Public schools in the United State are
mandated to provide an individual education program for students who meet certain
criteria for a learning disorders. The IEP sets learning goals and determines strategies
and services to support the child's learning in school.
■ Accommodations. Classroom accommodations might include more time to complete
assignments or test, being seated near the teacher to promote attention, use of
computer applications that support writing, including fewer math problems in
assignments , or providing audiobooks to supplement reading
■ Therapy. Some children benefit from therapy. Occupational therapy might improve
the motor skills of a child who has writing problems. A speech- language therapist can
help address language skills

■ Medication . Your child's doctor might recommend medication
to manage depression or severe anxiety. Medication for
attention-deficit/hyperactivity disorder may improve a child's
abiloty to concentrate in school.
■ Complementary and alternative medicine. Further research is
needed to determined the affectiveness of alternative
treatments, such as dietary changes, use of vitamins, eye
exercises, neurofeedback and use of technological devices.

THERAPIES :
The most common treatment for a
learning disability is special education or
speech and language therapy; however,
occasionally, medication can be tried to
enhance attention and concentration.
Because medication usually meets with
mixed results, health care practitioners

NURSING CARE
MANAGEMENT :
COMMUNICATION
Effective communication and interpersonal skills are
central to the nurse/patient relationship.Hospital
separates people from their ordinary lives and if the
patient has a learning disability this separation can be
distressing.
Communicating with people with a learning disability
seems to present difficulties for health providers . They
often fail to alleviate the sense isolation experienced by

► Assess the patient's communication skills and their
preferred method of communicating.
BEHAVIOUR
People with learning disabilities often have difficulty
adapting to new situations, therefore admission to
hospital may be more traumatic than for those who
do not have a learning disability.This means is
potential for problematic behaviour.

PREADMISSION
Where it is known that a person with a learning disability is
being admitted, several things can be done before the
admission takes place. It would be advantageous to:
✔ Talk to the patient, parents/carers and any health
professionals involved about the patient's communication,
and their likes and dislike;
✔ Assess the person with a learning disability's knowledge of
hospitals and address any potential fears;
✔ If possible, allow the patient to visit the ward/department
with thier carers and/or community learning disability nurse

POST ADMISSION
If a preadmission visit took place, ensure some familiar faces are
on duty on the day of admission. Nurses should :
✔ Be interactive, communicate, remain patient;
✔ Make eye contact;
✔ Look and listen;
✔ Encourage carers to visit;
✔ Allocate more time for the patient;
✔ Enable any nurses who may have experience with people with a
learning disability to care for the patient (but do not overuse this)

CONSENT
Nurses need to consider the capacity and ability of the person with a
learning disability to give informed consent . This means undertaking
a further assessment to determine capacity
This applies to all patients but particularly to patients with learning
disabilities. This means;
✔ Having effective communications with people with a learning
disability;
✔ Thorough assessment of needs so that valid and accurate information
can be given;
✔ Allowing time (and having patience ) to let the patient make her or
his own choice wherever possible;
✔ Where necessary remember the patient has the right to have an