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Harvard Commentaries
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Reviewed by the Faculty of Harvard Medical School

A Parent's Life A Parent's Life

Could Your Child Have a Learning Disability?

August 12, 2013

By Claire McCarthy

Boston Children's Hospital

Every child has some difficulty in school at one time or another, but usually it's nothing to worry about. Sometimes, though, it can be a sign of a learning disability. The question is, how does a parent know when there really might be a learning disability?

Experts use lots of terms to describe different learning disabilities, such as dyslexia, dysgraphia, dyscalculia or central auditory processing disorder.

What it boils down to is that the brains of some people have a hard time receiving, organizing, remembering or using information. People are different, with their own special strengths and weaknesses. The most common learning disability is trouble with reading, but some children may have trouble only with math, with understanding the spoken word, or with abstract (not "black or white") ideas.

Who Is Affected?

It's hard to know exactly how common learning disabilities are. About one out of every 20 children in public schools receives services for learning disabilities. That number may be on the low side, as the total number of children with a learning disability is believed to be even higher.

In fact, some people go well into adulthood without ever having their learning disability discovered. These individuals suffer school problems and poor self-esteem that may have been avoided with the proper help. While some learning disabilities are not easy to pick up, others can be diagnosed as early as preschool.

It's important to remember that having a learning disability doesn't have much to do with intelligence; people with learning disabilities usually have average to above-average intelligence. While we do not expect to "cure" a learning disability, we do know that we can help someone who has one learn ways to be successful in schoolwork. This is why it's so important to pick up on a disability as early as possible.

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Warning Signs

The Coordinated Campaign for Learning Disabilities lists warning signs for both preschool and early school-aged children.

Some possible warning signs in preschoolers are:

  • Late talking
  • Being slow to learn words
  • Problems with pronouncing words
  • Trouble remembering colors, numbers or letters
  • Trouble following directions
  • Difficulty talking and playing with children the same age

Some possible warning signs in early school-aged children are:

  • Trouble connecting sounds with letters
  • Difficulty remembering basic (simple, everyday) words
  • Continuing to reverse letters (such as b/d), flip over letters (m/w), or mix up letters and words
  • Having a hard time with basic math facts
  • Not being able to recall facts
  • Trouble learning new skills
  • Memorizing things more than understanding them
  • Showing poor coordination — for example, having trouble holding a pencil
  • Not making friends well or even being able to have social conversations

Again, these are just possible warning signs. Lots of children will show one or more of these signs and not have a learning disability. However, if your child is showing two or more, you should watch closely. If he or she doesn't seem to be improving over several months and is not doing well around children or in school (for example, poor grades), discuss your concerns with a professional.

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Talk to the Teacher and the Doctor

So what should you do if you think your child may have a learning disability? First, talk with your child's teacher, who can give you more information and be the best advocate for your child to get an evaluation to better understand what is going on. The U.S. government requires that all public schools do evaluations of children when a disability of some kind is known or suspected, and then, based on the results, make an Individual Education Plan (IEP) geared to each child's needs.

Some, but not all, private schools have testing available. And they don't have the same requirements to provide help. If testing isn't available at your child's school or you want a second opinion, many psychologists and medical centers offer educational testing. Be aware, though, that waiting lists can be long. And your health insurance may not cover the cost (which can be significant).

Of course, be sure to also make an appointment with your child's pediatrician if you are concerned that your child may have a learning disability. Some medical conditions (for example, a hearing or vision problem, or rarer and more serious problems such as epilepsy) can cause signs that resemble a learning disability. Your pediatrician also can help get your child the testing and help that's needed.

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ADHD and Learning Problems

While not exactly a learning disability, Attention Deficit Hyperactivity Disorder (ADHD) is another problem that can affect how well a child does in school. Children with ADHD are impulsive, easily distracted, have a hard time paying attention and sticking to tasks, and are often overly active. Your child's pediatrician is also the one to talk with if you are concerned that your child may have ADHD.

There are some straightforward questionnaires recommended by the American Academy of Pediatrics (AAP) and the National Initiative for Children's Healthcare Quality (NICHQ) that you and the teacher can fill out to help you better understand your child's behavior. Your pediatrician may refer your child to a psychologist or psychiatrist. Once this diagnosis is made, there are behavioral and medical treatments for ADHD that can make all the difference in the world for your child.

So if your child is having trouble in school, and you think there are signs of a learning disability, talk with your child's teacher and doctor. That way, you can catch any problems that may exist early, and give your child the best chance for success.

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Henry H. Bernstein, D.O., is a Senior Lecturer in Pediatrics at Harvard Medical School. In addition, he is chief of General Academic Pediatrics at Children's Hospital at Dartmouth and Professor of Pediatrics at Dartmouth Medical School. He is the former associate chief of General Pediatrics and director of Primary Care at Children's Hospital Boston.

Claire McCarthy, M.D., is a senior medical editor for Harvard Health Publications. She is an assistant professor of pediatrics at Harvard Medical School and medical director of the Martha Eliot Health Center, a neighborhood health service of Children's Hospital. She is also a contributing editor for Parenting Magazine.

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