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We Need to Change How Kids With Learning Differences are Diagnosed and Treated, Study Author Says

A University of Washington study on dysgraphia, dyslexia and other oral and written language learning disabilities analyzes brain activity

little girl reading

A study from the University of Washington shows that while some children have more difficulty than others learning to read and write, not all of them have the same kinds of struggles, says lead author Virginia Berninger, a professor of educational psychology at the UW College of Education.

Tests and brain imaging can identify three different kinds of specific learning disabilities, the study found: dysgraphia (trouble writing individual letters legibly and automatically), dyslexia (trouble reading and spelling words) and oral and written language learning disability (trouble using series of ordered words to comprehend through listening and reading and expressing ideas in talking and writing).

The brain imaging also showed that children with learning differences had much greater activation of a structure in the limbic system, known as the emotional center of the brain, than the control group, which had no learning differences, Berninger says.

The findings highlight the need to change how children with learning differences are diagnosed and treated, she says.

As a parent of a child with learning issues, I want to know what this study, published in April in the journal Reading and Writing, means for my daughter and children with similar issues. Berninger spoke with me about her research and her more than 40 years of teaching, clinical assessment and research work in the learning differences field. Here’s what she had to say.

Tests in public schools usually don’t identify specific disabilities. Instead, these tests are answering the question of whether this student qualifies for services. Why is differential diagnosis — identifying specific differences by individual — important?

The analogy I give is let’s say you are not feeling well so you go to the doctor. What if no matter who walks in the door, the doctor says, "you are sick so I am going to give you aspirin"? When you diagnose someone, you have to rule out what’s not wrong and identify what is wrong. A lot of learning disabilities share common symptoms, but what is unique is what's going to help the individual get better. With learning differences, if you identify what is wrong, you can treat the issue.

There’s a lot of work yet to be done in this field. We didn’t have national recognition of learning disabilities until 1975. That’s 40 years ago. And public education has only been around since 1850. In the history of human civilization, education outside the home is relatively new. It’s not a perfect system, but it could be a whole lot better.

How can public schools go about testing, and how can they best help these struggling students?

With the current model, no two states or frankly no districts within a state are identifying children in the same way. Furthermore, none of the research has shown that pulling students out of the classroom to obtain help actually works. And there’s no way we can afford to pull one out of five students.

What we do know from research is which oral language, reading, writing and math skills are key for learning at each grade level from kindergarten through fifth grade. If schools just screened for each of these each year, and provided special instruction in the regular program for students who struggle in specific skills, many learning problems could be prevented. For example, learning to form letters and the sounds that go with each letter or letter group is very important in the early grades. But in grade 4 the curriculum changes and most of the reading is silent rather than oral, and the requirements for spelling and expressing ideas in writing skyrockets.

It’s much easier for the student if we start early by looking for flags and addressing issues. Yes, learning differences are treatable at any age, but the students experience less pain by starting earlier. And we prevent bigger issues later on through early intervention.

keyboard keys abc letters

How will changes like this get made in school systems?

The good news is that there are effective ways to help these children and turn this around. This body of knowledge is not getting translated in a way that we can benefit many children, but it can be done. We know this because there are places where teachers are doing so.

There is debate among federal lawmakers about changes in legislation, and in some states there are similar debates among state legislators about changing state department of education policies. We can use research to make a better system, and we don’t need to blame the teachers.

The federal government needs to require that schools screen and intervene at each grade level and not tie services to a single test. We have to define the skills that we need to screen for, and we need to define how the skills need to be taught. Much more can be done at the school level, too. We need to prepare not just teachers but the administrators.

The current system was set up by lawyers and legislators. People who are not educators have made the policy. Right now, unless parents advocate, which sometimes involves threatening an attorney or getting an attorney, children’s needs are not getting met. That’s not right. We need a new system that advocates for kids and that include best professional practices that come from educators and researchers.

The part of the study where brain scans show greater activation in the emotional areas of the brain in students with learning differences interests me. As a parent of a child with dyslexia, it’s abundantly clear that my daughter has anxiety and social emotional distress due to her struggles in school. Tell me more about this part of the study.

If not identified and treated, learning differences can become disabilities that are invisible to others. These disabilities are in our minds and brains. We have a learning mechanism system that helps children learn. It’s inside the head and there are multiple components. If any one of those components isn’t working right, they are going to really struggle, and other people aren’t going to see it and understand it.

The brain is kind of like an orchestra in that it has multiple instruments connected in time and space. These parts may play together at the same time, or they may not play at the same time. With brain scans, we saw that children with learning differences have connections to the limbic system or social emotional brain that kids without learning differences did not have.    

I also know about these issues from working with children with learning differences who are in our after-school program. We listen to the children. What they tell us is no one understands how hard they have to work to accomplish what their classmates accomplish: "My classmates spent an hour and I spent four." Sometimes teachers and parents think these students don’t try hard enough. Actually, they are more motivated. They have worked very hard and are very frustrated. Most people don’t understand that they are really hurting. Some will act out but many don’t, or they don’t act out all the time.

The limbic system contains the amygdala, which is the part of brain involved with fear and anxiety. These kids are scared! And they are very concerned with their self-concept. We’ve asked these kids how teachers can help more. So many have told us that they learn the most when they have teachers who get kids. The kids will say, "I know they like me and that they care and that they like the other kids in the class." We are so focused on teaching skills, we are forgetting the human part of teaching.

I’m trying to get across to people that we can help these children with their social-emotional issues by strengthening the human connection. For example, at the end of the school day, the teacher has a compliment circle. The teacher needs to understand each student's dependable strengths and say these strengths out loud. Then the other kids will hear the strengths of kids with learning differences, too. And the students with learning differences will know that oral reading is not the only thing that matters in school.

Schools and parents need to build their communities proactively, too. If everyone talks to each other, we all know we are connected and we have an easier time meeting everyone’s needs.    

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