Chapter 7

LD Jargon (blah, blah, blah….)

Words to know for chapter 7:

Jargon – confusing terms that sound important

Dyslexia – reading difficulty

Dysgraphia – writing difficulty

Dyscalculia – math difficulty

Diagnose – being identified with a certain disorder

Nonverbal Learning Disorder (NLD) – difficulty processing visual or nonverbal information

Central Auditory Processing Disorder (CAPD) – difficulty processing auditory information

Attention Deficit Hyperactivity Disorder (ADHD) – a medical condition causing difficulty paying attention and poor impulse control

Executive Functioning – overall regulation of several types of processing

Theoretical – an idea that has not yet been proven

Controversial – causing differing opinions or even arguments

Impulsive – jumping into things or acting without thinking

Subjective – based on opinion rather than solid proof

Productive – getting things done

Irresponsible – ignoring responsibilities and just doing what you want

'So far we have attempted to avoid using too much educational or psychological 'jargon' but it is time to deal with some of the more common and often confusing LD terms. In most cases you will find that the terms sound much more serious and complex than they really are.'

'Let’s get started…..'

Dyslexia, dysgraphia, and dyscalculia:

Although these three terms refer to different learning problems, we will discuss them together because they have several common features.

Dyslexia is probably the most common LD term which the general public hears. The word 'dyslexia' simply means difficulty understanding written words. In other words, it just means 'reading difficulty'.

Similar to dyslexia, the term 'dysgraphia' simply means 'writing difficulty'. Generally it is used to refer to poor handwriting and is sometimes identified as a 'disorder of written expression'.

As you have probably guessed, the term 'dyscalculia' refers to 'math difficulty' and specifically means a learning disorder which affects math.

So are dyslexia, dysgraphia, and dyscalculia considered learning disabilities?

Not necessarily. As mentioned in Chapter 1, there are very strict criteria which determine if a student has a learning disability as it is defined by special education rules. When a student’s reading, writing, or math difficulty is severe enough to meet this criteria, then it is considered a 'learning disability' and special education services may be needed. On the other hand, dyslexia, dysgraphia, and dyscalculia have no real criteria.

It is important to understand that there are no rules for determining how severe a learning problem needs to be before a diagnosis of dyslexia, dysgraphia, or dyscalculia can be made. As a result, many students with mild reading, writing, or math difficulties are 'diagnosed' with one of these disorders but do not actually have a learning disability. That causes lots of confusion for parents and is why the terms are rarely used in public schools.

Nonverbal Learning Disorder (NLD or NVLD):

A nonverbal learning disorder (often referred to as a nonverbal learning disability) is sometimes diagnosed when a student’s learning difficulty is believed to be caused by weakness in the ability to process nonverbal information. Usually, such a student performs quite well verbally (listening, writing, and speaking) but struggles to understand or remember information which is presented visually. This is not due to poor vision but is related to an assumed weakness in the brain’s ability to process nonverbal information.

This sounds exactly like a visual processing disability as it was described in Chapter 4.

That’s right, NLD is really just another way to describe a visual processing problem. So as we learned in Chapter 4, the most important factor in diagnosing a true nonverbal learning disorder is the identification of an overall weakness in nonverbal or visual processing skills. Students with nonverbal processing weakness will usually struggle most with academic tasks which involve complex or abstract visual displays (charts, graphs, maps, etc.) and when there is not much verbal or auditory information. These students will generally have most difficulty in the areas of math and spelling (due to poor visualization) but may also struggle with hands-on activities (science labs, etc.). Reading and creative writing skills may be relatively strong.

Are there any other characteristics of NLD?

Some students who experience a visual processing weakness also demonstrate somewhat unusual social and behavioral issues which set them apart from other LD students. These issues frequently include difficulty accurately understanding social situations, confusion with nonverbal communication (like gestures or facial expressions), and general avoidance of social situations. Because these characteristics can be very similar to behaviors of students with autism, it is sometimes difficult to determine if such a student should be diagnosed with a nonverbal learning disorder (NLD) or with an autism spectrum disorder (ASD). When a student demonstrates significant visual processing problems along with social, communication, and behavioral confusions, it may be important to consider the possibility of both NLD and ASD.

Central Auditory Processing Disorder (CAPD):

A Central Auditory Processing Disorder is sometimes diagnosed when the cause of a student’s learning difficulties is believed to be a weakness in the ability to process verbal or 'auditory' information. Usually, such a student performs quite well nonverbally (with visual or 'hands-on' activities) but struggles to understand or remember information which is presented verbally. This is not due to poor hearing but is related to an assumed weakness in the brain’s ability to process auditory information.

This sounds pretty much like an auditory processing disability as it was described in Chapter 4.

Right again! Central Auditory Processing Disorder (CAPD) is really just a very fancy term to describe an auditory processing weakness. And as we learned in Chapter 4, the main factor in diagnosing a true auditory processing disorder (such as CAPD) is the identification of an overall weakness in verbal or language-based information processing skills. Students with real auditory processing weakness will usually struggle most with academic tasks which involve lectures or written instruction and which provide limited visual or nonverbal information. These students will generally have most difficulty in the areas of reading and writing due to difficulty processing or expressing language-based information. Math will probably be relatively strong.

What other problems are related to CAPD?

Students who receive the diagnosis of CAPD also often have difficulty paying attention, memorizing information, and planning or organizing tasks. As we learned in Chapter 5, such problems with memory and organization are often related to sequential processing weakness but can also be related to an attention deficit hyperactivity disorder (described later in this chapter). So whenever the CAPD diagnosis is being considered it is very important not to overlook the possibility of a sequential processing weakness or ADHD.

OK, so NLD and CAPD must be considered learning disabilities, right?

Sometimes, but not always. As we learned in Chapter 1, there are always two parts to a true learning disability:

So although a diagnosis of NLD or CAPD certainly suggests an information processing problem, before a learning disability can be identified there would also need to be proof that the processing problem has caused severe underachievement.

Attention Deficit Hyperactivity Disorder (ADHD):

An attention deficit hyperactivity disorder is a medical condition which affects a person’s ability to concentrate and maintain attention to tasks. It is believed to be caused by a lack of certain brain chemicals that help you to filter out distractions and control behaviors.

What is the difference between ADD and ADHD?

Although there used to be a separate ADD diagnosis (related to an attention deficit disorder without hyperactivity), currently there are three different diagnoses within the broad category of Attention Deficit Hyperactivity Disorder (ADHD):

As the names imply, the 'inattentive' form of ADHD primarily involved issues related to inattention (daydreaming, drifting off tasks, etc.) while the 'hyperactive' form involves significantly increased activity level and impulsiveness. And obviously, the 'combined' form involves both inattention and impulsiveness.

How is ADHD diagnosed?

ADHD is a medical condition which requires a medical diagnosis (by a medical doctor or psychiatrist). Although it is a medical condition, ADHD cannot be diagnosed by any type of laboratory test. The diagnosis is based upon a set of behavioral characteristics, and as such, can be a very subjective process. Often the doctor or psychiatrist makes the diagnosis based upon observation of the child and interview of the parent about behavioral characteristics which are observed at home or at school. Frequently the school will also be involved in the process either as part of an evaluation for possible special education services or simply through behavior ratings which are completed by teachers.

It is very important to remember that ADHD is not diagnosed by the school, but the school can provide important information to help with the diagnosis.

How common is ADHD?

It is estimated that somewhere between 2% and 10% of the population is experiencing some form of ADHD. But since the condition involves behavioral characteristics which can range from very mild to extremely severe, many undiagnosed students may exhibit behaviors very similar to those of students who are diagnosed with ADHD. And since the diagnosis itself is very subjective, it is not possible to accurately determine how many people really have ADHD.

Is ADHD a learning disability?

Technically, ADHD by itself is not considered a learning disability or any other special education handicap as defined by Federal Special Education rules. However, since students with ADHD experience many of the same processing difficulties that are experienced by LD students, they often are found eligible for special education services within the category of LD. In other words, it really depends on how well the student is able to cope with his or her ADHD. If the ADHD 'severely' impacts the student’s academic skills and classroom achievement (causing severe underachievement), then an LD diagnosis may be appropriate.

What about medication?

When a child is diagnosed with ADHD, often one of the most difficult decisions is whether or not to treat the condition with medication. Typically, the medication prescribed is some form of 'stimulant' - most commonly Ritalin. Although it may seem wrong to give a stimulant to a person that is already impulsive or hyperactive, stimulant medication is believed to help stimulate the brain’s production of the natural chemicals needed to stay focused and control behavior. This type of medication is quite safe and usually very effective, but parents are wise to at least consider the potential side effects which often include loss of appetitive and sleep disturbance. On the positive side, appropriate medication, when introduced at an early age and combined with positive behavioral interventions, is often very effective for treating ADHD and helps to avoid long-term educational problems. When introduced at later ages, medication is somewhat less effective because it is difficult for people to “unlearn” bad behavior patterns. While the medication may 'allow' a student to make better behavioral choices, the choices are still his or hers to make. And as we all know, negative habits are especially hard to break.

If a child starts on medication, do they need it for the rest of their life?

Studies have suggested that approximately 50% of students who required medication in elementary grades are able to cope without medication by high school. This may be due to a combination of neurological development and learned behavioral changes. The other 50% of these students may benefit from the medication for most of their adult lives.

Executive Functioning:

Executive Functioning is a somewhat controversial term being used within the educational and mental health communities. Executive Functioning refers to a person’s ability to manage or regulate several basic cognitive and emotional processes. This includes planning, initiating (starting), organizing, and completing tasks as well as the ability to cope with transitions or control emotional responses. It is basically like an executive in a company or organization who oversees and manages several different departments. Without an effective 'executive' who can coordinate all of the various departments, the overall company is less efficient and therefore less productive. Similarly, a student with poor executive functioning skills tends to be less productive or successful in school or in life.

Executive Functioning skills involve:

• ability to stay focused on tasks

• ability to plan and anticipate

• organization of thoughts and materials

• ability to follow-through and complete tasks

• ability to cope with unstructured situations

• ability to cope with changes in routine

• ability to control emotions

Students experiencing general executive functioning difficulties often struggle academically with work-completion, organization, and motivation for any task which is perceived as difficult, frustrating, or simply unappealing.

Is an executive functioning problem considered a learning disability?

Not really. Although most students with learning disabilities appear to have at least some executive functioning difficulties, similar difficulties are also frequently seen in students who do not have learning disabilities. In fact, most teenagers display executive functioning problems from time to time. While the concept of executive functioning certainly makes sense, it is strictly theoretical (meaning there is no real proof that it exists) and there is considerable uncertainty and disagreement about whether it is actually a form of cognitive processing or more of a personality trait. In fact, it is very difficult (if not impossible) to tell the difference between a student who is experiencing a real executive functioning problem and a student who is simply unmotivated or irresponsible. As it relates to a learning disability, executive functioning is a bit of a chicken vs egg situation because you can’t tell which is causing the other. While students with specific areas of information processing difficulty often also display overall executive functioning problems, this may simply reflect a breakdown in the overall 'organization' caused by a single ineffective 'department'. Or it can be related to a general lack of motivation brought about by years of failure and frustration.

Is difficulty with executive functioning related to ADHD?

The symptoms of executive functioning difficulty are very similar to the symptoms of ADHD. In fact, evaluation of executive functioning is becoming a common part of ADHD diagnosis. Unfortunately, as with a learning disability, it is unclear if an apparent executive functioning difficulty is actually the cause or the effect of the attentional difficulties.

What can be done to improve executive functioning?

Students with executive functioning issues tend to respond well to increased structure, routine, and predictability in their lives. The use of lists and schedules can help a great deal. The important thing to remember is that you are trying to develop better executive functioning skills in order to be more productive and less irresponsible. A common problem occurs when your parents or teachers simply perform the executive functioning tasks for you rather than helping you learn to perform the tasks for yourself. While it may be necessary and appropriate for parents or teachers to initially help you develop lists, schedules, routines, and other structures to 'get the job done', when parents or teachers do too much for too long, your executive functioning problem actually becomes more significant and unmanageable.

'Wow! Some of that jargon is pretty confusing. But it seems that the terms really aren’t as scary or serious as they may sound. I prefer to keep things simple and avoid too much jargon whenever possible!'

Review Questions:

1. True or false: If you have been diagnosed with dyslexia you definitely have a learning disability and need special education services.

2. What kinds of learning problems are related to dyslexia, dysgraphia, and dyscalculia?

3. What is the primary processing problem associated with a nonverbal learning disability (NLD)?

4. What are some characteristics of autism which are sometimes associated with NLD?

5. What is the primary processing problem associated with a central auditory processing disorder (CAPD)?

6. True or false: The characteristics of CAPD are often very similar to symptoms of ADHD.

7. What are the three forms of ADHD?

8. True or false: ADHD must be diagnosed by a medical doctor or psychiatrist.

9. True or false: ADHD is a type of learning disability and always requires special education services.

10. True or false: Executive functioning in your brain is like an executive in a company who is in charge of several different departments.

11. Give one example of how an executive functioning problem is like ADHD.

12. Give one example of something you can do to improve your own executive functioning.

13. Why do lazy or irresponsible students appear to have executive functioning problems.