L

learning disorders Difficulties with cognitive
functions such as analytical thinking, reading,
writing, speech, listening, comprehension, and
memory. Learning disorders are neurologic and
arise from physical disturbances in BRAINfunction.
Such disturbances may be due to abnormalities in
brain structure that occur during fetal develop-
ment, injuries to the brain that result from oxygen
deprivation during PREGNANCY or CHILDBIRTH, or
TRAUMATIC BRAIN INJURY(TBI) during childhood. Fre-
quently, however, the reason for a learning disor-
der remains unknown. Though social factors
influence the extent to which a person who has
learning disorders is able to overcome challenges,
such factors do not cause learning disorders.

Symptoms and Diagnostic Path

Often the first indication of a learning disorder is a
gap between a child’s abilities and the abilities that
are normal for the child’s age. Depending on the
type of disorder, this gap may become apparent
early in childhood or be detected when the child
starts school. Symptoms may include a child’s
inability to

• speak in sentences by age 3


• speak clearly enough for others to understand
  by age 3


• tie shoes and fasten buttons by age 5


• sit still through the reading of a short story by
  age 5


• read and write as expected for age or grade
  level

Some learning disorders also involve deficits in
motor skills and physical coordination. Because
the rate and nature child development varies

widely, diagnosing learning disorders is often chal-

lenging. The diagnostic path may incorporate

numerous approaches including neurologic,

vision, hearing, and speech pathology evaluations;

psychologic testing; achievement testing; and

classroom observation. It may be difficult to reach

a clear diagnosis; test results may be inconclusive

or inconsistent. In the United States, diagnostic

testing and remedial or adaptive educational serv-

ices are available at no cost to families for all chil-

dren from birth to age 21.

Treatment Options and Outlook

Treatment is often multidisciplinary, integrating

alternate learning approaches with appropriate

PHYSICAL THERAPY, speech pathology, OCCUPATIONAL

THERAPY, and counseling. Treatment efforts may

involve the entire family. The rate and extent of

progress varies widely and depends on multiple

factors. Many people learn to compensate for their

learning disorders to the extent that they are able

to lead normal, productive lives. For some people,

learning disorders present lifelong challenge.

Risk Factors and Preventive Measures

Because learning disorders result from neurologic

damage, they are very seldom preventable. Appro-

priate PRENATAL CAREis important to provide opti-

mal opportunity for healthy fetal development

and growth. Appropriate care during childbirth

and in the immediate newborn stage is especially

crucial. Some learning disorders, such as dyslexia

(difficulty reading), appear to run in families,

leading researchers to believe genetic components

may be involved.

See also APHASIA; APRAXIA; ATTENTION DEFICIT

HYPERACTIVITY DISORDER(ADHD); CEREBRAL PALSY; COG-

NITIVE FUNCTION AND DYSFUNCTION; DOWN SYNDROME;

258