Learning Disabilities in 2023: Diagnosis, Assistive Technology, and Website Accessibility

Learning disabilities (LDs) have different names in different countries, but they all refer to a person’s problems with assimilating, processing and/or reproducing learning content in a typical manner. For the purposes of this article, we will focus on the American definition and diagnosis.

According to the Learning Disabilities Association of America, a learning disability is a neurological disorder that affects information processing. Simply put, this means that a person experiences difficulty learning and processing information in a conventional learning environment.

They are subcategorized into a long list of disorders and difficulties, and most are inherited:  parents have experiences of their own that may help them understand their child’s challenges. It is important to note that there is no ‘one-size-fits-all’ diagnosis or even definition of these disorders.

Symptoms differ in terms of severity and scope, and they overlap with other learning problems. This can lead to emotional and behavioral maladaptation, especially in children.  Also, cultural differences in an eclectic class, as well as learning in a language other than the mother tongue, can easily present as learning disorders.

Broadly speaking, LDs fall into four categories based on the four stages of information processing in learning.

Visual and Auditory Input

Learning takes place through visual and auditory perception, and is the most common area where deficits can manifest. Problems include difficulties recognizing the shape, position and size of an object; difficulties with sequencing such as sequencing of sound (speech); focus problems due to an inability to screen out an auditory stimulus etc.

Integration of Prior information from study and experience

Integration of learning material involves interpretation, categorization, sequencing and relation to previous learning material or experiences. Students with integration problems may be unable to remember the sequence of a story; cannot memorize sequenced information such as the months in a year; show understanding of a concept but cannot apply it to other areas of learning, and/or are unable to view information globally.

Storage

Data retention problems present in short- or long-term memory. If a student has storage issues, he or she may not be able to learn how to spell or read properly.

Output: Words and Motor Skills

This refers to language output involving the spoken word or motor skills such as writing, drawing or gesturing. Students experiencing problems with language output will demonstrate difficulty with the spoken language, such as answering a question on demand. Motor skill issues can manifest as difficulty writing legibly, holding a pen correctly etc.

The four most common learning disabilities are, in short:

1. Dyslexia – This learning disability affects a person’s ability to read and make sense of text.
2. Dyscalculia – A person suffering from dyscalculia battles to work with numbers, and experience difficulty in acquiring arithmetic skills.
3. Attention Deficit/Hyperactivity Disorder (ADHD) – This disorder manifests as a person’s continuous inability to concentrate or pay attention. In addition, uncontrolled impulsivity and hyperactivity impede the person’s normal functioning and, in children, impede their development.
4. Dysgraphia – A person suffering from dysgraphia experiences difficulty or impediments in handwriting and fine motor skills in general.

What are the Symptoms of a Learning Disability?

As with all disorders, it is always better when learning disorders are spotted and treated or managed from an early age. In order for a disability to be diagnosed, one or more of the following symptoms must persist and impede the student’s ability to work and function normally:

• Inappropriate responses to normal situations.
• Impetuous and impulsive.
• Easily distracted from the task or game at hand.
• Immature speaking patterns.
• Difficulty listening well.
• Problems understanding words and concepts such as numbers.
• Difficulty expressing themselves with words.
• Inconsistent performance at school.
• Difficulty dealing with change.
• Problems with reading, writing and math.
• Difficulty following directions.
• Problems with understanding the concept of time.
• Poor physical coordination.

These are signs that could alert a parent or educator that a child may be suffering from a learning disability, but only specialized tests can confirm a diagnosis.

How is a Learning Disability Diagnosed?

Diagnosing learning disabilities is complex, as they are often comorbid with other disorders, and contention exists among experts on which diagnostic model accurately identifies learning disorders.

However, Response To Intervention (RTI) was adopted in 2004 in American schools as a good way to address symptoms of learning problems. If the intervention proves unsuccessful, RTI results can be used as an identifier of a specific learning disorder. In Florida, it is the primary means of diagnosing learning disabilities.

Diagnosing a LD using RTI is a multi-tiered process, followed by tests and other assessments, and it starts in the classroom.

Response To Intervention (RTI)

As a rule, Response To Intervention is not used as the only diagnostic tool for learning disabilities. Rather, it forms part of an intervention process that involves some steps toward a positive diagnosis.

RTI is a set of strategies designed to help a student succeed in the classroom when it becomes clear that he or she is not coping. It addresses both learning and behavioral issues.

RTI strategies are divided into a three-tier intervention process:

Tier One Strategies – These are common teaching strategies usually employed in class to explain or demonstrate more intricate subject matter, and not necessarily to only the students who present with problems.

Tier Two Strategies – If a student doesn’t respond well to Tier One strategies, additional small-group classes are added to the core curriculum. They usually take the form of extra 30-minute classes, and involve only the struggling students. In this tier, the strategies are more specific and subject-related, and they aim to break down information in smaller segments or steps.

Tier Three Strategies – If students are not responsive to Tier Two strategies, they are moved onto Tier Three, which is a lot more individualized, and involves working one-on-one or in very small groups of two or three. The teacher differentiates in terms of individual learning styles, and strategies may be specific for each student.

As students progress, they return to the previous tier as they improve. The situation calls for special tests and assessments if they do not improve satisfactorily. These can include:

• A full physical examination, including a neurological assessment by a medical professional, in order to rule out organic causes of the learning disability.
• Assessment of a child’s developmental, school and social performance.
• Involving parents to discuss the family history.
• Psychological assessments by a psychologist or suitably qualified mental health practitioner.
• Achievement tests determine what is needed for intervention.

The advantage of the RTI model is that problems can be picked up before the student lags behind too much in their work. Complete failure can be prevented, with less students needing time-consuming, expensive specialized educational services.

Previously, schools relied heavily on the IQ-achievement discrepancy model as a diagnostic tool for identifying learning disorders. However, researchers have criticized this approach, with proof that the discrepancy between a measured IQ and academic achievement is not a clear indicator of a LD. Students who scored low on IQ tests and performed poorly at school, responded to intervention as much as students with a high IQ score but performed poorly at school.

How can a Learning Disability be Managed?

The current view is that most learning disabilities are incurable and can, at best, only be managed. Also, it is better when management is started at a young age. Fortunately, with assistive technology, this is no longer an impossible trial for parents, teachers and those suffering from an LD.

Assistive Technology for Everywhere and Every Day

The following are suggestions – the list is by no means fully comprehensive.

• Paper-based computer pens – These pens link what the person hears to what they write. It involves the use of special paper and the pen, which records and links the writing to the auditory input. This AT will assist people with LDs related to listening, writing, data retention and organizing. You can choose from different types of pen scanners to find a suitable product. E.g. Echo Smartpen and Wizcom reading pen.
• Personal FM listening systems – This system feeds a speaker’s voice directly into the listener’s ear. This makes it easier for people struggling with attention and listening to focus. E.g. Easy Listener.
• Personal Data Managers – These tools make use of portable devices and online computer software to help a person store, manage, organize, and retrieve personal data like contact details, calendars, notes etc. It will help with LDs with memory and organization. E.g. Memo To Me.
• Variable-speed control (VSC) recorders – A VSC recorder can record speech, which can later be played back at various speeds, without voice distortion. Persons’ battling with listening, retention and organization will benefit from this device.
• Electronic math worksheets – If a person battles to convert math problems onto paper, electronic math worksheets may be of help. It comprises computer software that organizes, aligns, calculates and work through math problems step-by-step. Some programs can read numbers appearing on the screen out loud, to provide auditory stimuli as well. E.g. MathTalk
• Audio publications and books – Available online, on CDs and as MP3 downloads, recorded books and articles are wonderfully helpful tools for persons with LDs related to reading. E.g. Bookshare.
• Optical character recognition (OCR) – With this technology, text can be scanned onto a computer, a stand-alone unit or handheld device, and with a screen-reading system, be read back to a user. Some can even convert the scanned text into braille. E.g. ReadingPen.
• Abbreviation expanders and prediction text – This computer software lets users create, store, and re-use abbreviations for frequently-used words or phrases in word processing. It also predicts text for the user after only typing a few letters. Especially helpful for those battling with writing. E.g. Penfriend.
• Programmable keyboards – These keyboards have a special overlay that allows the user to customize it according to his/her needs. For instance, typing input can be reduced, keys can be organized by color and location, and graphics can be added for enhanced comprehension. This is an exceedingly helpful tool for persons with LDs in reading and/or writing. E.g. Intellikeys.
• Organizing and outlining programs – With this software, a student can dump unstructured data into the program, and the program will assist with organizing and outlining the information. It is a helpful tool for those LDs related to organizing and writing. E.g. DraftBuilder.
• Proofreading software – This software is usually already built into word processing programs and can be activated or deactivated. The software scans writing for errors in grammar, spelling, punctuation, word usage, and sentence structure and makes corrective suggestions. Independent, downloadable software that can do the same: Grammarly.
• Talking calculators and word processors (screen readers) – Talking calculators (helpful assistants in the case of LDs related to math and numbers) synthesize a voice that is capable of reading numbers, calculations and answers. Talking word processors use voice synthesizers to read text of various lengths to the user. It reinforces the writing process with auditory input and can assist a person with writing difficulties. E.g. text help
• Software programs for speech recognition – This software allows a user to dictate into a computer’s microphone, and have the speech converted into text. It usually works with a word processing program, and will assist persons battling with writing. E.g. Nuance and Penpower Junior.

How Website Accessibility Helps Those with

Up until a few years ago, the only concession made for internet users with LDs, was to improve browsing formats for the visually impaired. Fortunately, this situation is changing rapidly as awareness and new technologies emerge. It will serve webmasters well to observe the following points:

1. Use detailed alt tags – Alt tags are used instead of captions for images, as words pop up when one moves the cursor over a picture. When a learning-disabled person uses a screen reader, the computer reads the caption out loud, and makes the image more accessible for the user. Details such as names of places and people, or dates can be added to the alt tag to truly bring the image alive, especially for the reading and comprehension impaired.
2. Subtitles and transcripts – This convention can make a video recording or images, more accessible for the hearing impaired.
3. Periods in abbreviations – Periods in abbreviations will ensure that screen reader read it as an abbreviation instead of a word. Imagine trying to pronounce ‘FBI’ as a word…
4. Descriptions for links – Instead of writing, ‘To learn more about assistive technology, click here’, a detailed description of the embedded link would be helpful. Example: ‘To learn more about assistive technology, have a look at Prof. Tech’s Ted Talk here.’ Also, underlining, or using color contrast between embedded links and normal text will make the links more accessible for visually impaired readers.
5. Enlarge clickable content – For mobility-impaired users, a large clickable icon, image or text will be helpful.
6. Streamline copy – Keeping content well-organized by dividing it in paragraphs, using clear headings, and writing in shorter sentences wherever possible, will make it more accessible for just about everybody.
7. Create an accessibility guide – By creating a page with a clear guide for impaired users, any website should see a significant rise in user numbers. The BBC created an excellent video with guidelines for this guide.
8. Audio version of content – Making an audio version of the content available will greatly assist those with LDs in the reading spectrum.
9. Make navigation obvious – Clear buttons and navigation instructions will go far towards making the site accessible for persons with learning disabilities.

With these, and a growing number of other tools, a learning disorder need not be a disabling handicap.