teacher does not Chapter 7

else would you

lmsonlearning. com.
isorder, psychos-
Learning Disability

SYMPTOMS

Gisela Garcia was an 8-year-old Hispanic female referred to a school psychologist

for evaluation and recommendations for possible treatment. Gisela was in second
grade at the time of her referral. Gisela's parents, Mr. and Mrs. Garcia, dropped
their initially strong objections to an evaluation and consented to the referral late
in the academic year. Gisela had many difficulties with reading assignments and
spelling tests, despite the fact that English was her primary language. These
difficulties also affected Gisela's math and science perfonnance because many of
her assignments in these areas included story proQlems requiring extensive reading
and writing.
The school psychologist, Mrs. Dartil, was aware of Gisela's academic
problems for about 2 months. Gisela's second-grade teacher, Mrs. Martinez,
infonned the school psychologist that one of her students was having particular
trouble in reading and spelling, but that the girl's parents resisted additional
assessment or intervention. Mrs. Martinez hoped the school psychologist could
join her for a meeting with the parents to convince them of the need to evaluate
Gisela. Mr. and Mrs. Garcia reluctantly agreed to such a meeting after several
weeks of delay.
Mrs. Martinez outlined her student's academic problems at the meeting with
Gisela's parents and the school psychologist. Foremost was Gisela's reading and
spelling perfonnance, which lagged severely behind the rest of the class. Gisela was
currently in Mrs. Martinez's lowest functioning reading group and had trouble
paying attention to and understanding the material. Mrs. Martinez would read a
story to the group and then present questions about the story. Most of the children
readily answered simple questions about the story though many struggled with
more complex questions. Gisela, however, often had trouble answering even
simpler questions, such as "What animal was this story about?" Part of the problem
stemmed from Gisela's inattention - she sometimes sat on the floor and twirled
herself around as Mrs. Martinez read a story. She usually stopped after a reprimand,
but would soon continue.

75
76 C HA PTE R 7

Mrs. Martinez also said Gisela had trouble identifying new and different
words, even those in word groups such as law, paw, and saw. Each member of the
reading group read a short passage from a particular book. Gisela was usually able
to read the passage if it was covered within the past month. For relatively new
book passages, however, Gisela had trouble identifying almost every other word.
Gisela had no trouble identifying letters of the alphabet and, if given enough time,
could eventually decipher the meaning of a word and resume her reading.
Unfortunately, this often required a lot of time and disrupted the reading group.
Mrs. Martinez further explained that Gisela's reading problems related to her
spelling problems. Gisela had enormous trouble spelling words presented orally, as
on a test. She had little trouble copying a word from a book or rewriting the word
several times, however. The teacher required her students to study new words
given on a Monday by spending time rewriting the words during the week. The
oral test occurred on Friday. Gisela had little problem studying during the week
but wrote her words slowly. Her performances on recent oral spelling tests,
however, averaged only 30% correct. This supplemented other failures on rote
reading and writing assignments.
Mrs. Martinez further explained that Gisela's reading and spelling problems
affected her progress in math and science. This was primarily because the teacher
often taught math and science using story problems and creative lab projects (e.g.,
growing plants) involving reports and other written work. These assignments
would thus be difficult for someone struggling with reading and writing. Gisela
had little trouble with hands-on work or with tasks that captured her interest and
attention, however.
Mrs. Martinez thought Gisela was functioning academically at an early first­
grade level. The teacher also said Gisela seemed "bright" and had several strengths
in school, however. Gisela excelled in music and art class, taking a keen interest in
activities there and showing strong motivation. Gisela's strengths also included
social skills. She was witty, higWy interactive, and one of the best liked children in
the class. Gisela's verbal skills were also normal. Mrs. Martinez said Gisela seemed
of normal intelligence, but certainly struggled with assigned schoolwork.
Mrs. Martinez then commented on Gisela's classroom behavior. The teacher
said Gisela was somewhat fidgety and had trouble paying attention but was not
disruptive. Gisela was not aggressive, higWy overactive, impulsive, or impolite. Gisela
was generally compliant but needed constant reminders to stay on task. Mrs. Martinez
also said Gisela's classroom materials and study skills were extremely disorganized.
Her desk was stuffed with irrelevant papers and writing instruments. She also had no
systematic way to prepare for tests, complete assignments, or tell time.
Gisela's parents, Mr. and Mrs. Garcia, did not receive these reports well. They
adamantly refused to believe their daughter had an internal problem, blaming the
school instead (and, indirectly, Mrs. Martinez) for "bad teaching practices." They
said Gisela performed well the previous year in another state, but refused to release
those educational records to the school psychologist. They also said Gisela
concentrated well at home and finished her schoolwork when they supervised her.
They claimed Gisela had no trouble paying attention to them and that, overall, she
was a normal 8-year-old.
 LEARNING DISABILITY 77

:w and different Mrs. Martinez responded by saying Gisela may have completed her
h member of the homework, but few assignments were turned in (Gisela often claimed they were
was usually able lost). The teacher recommended that Mr. and Mrs. Garcia observe their daughter
>r relatively new in her reading group and closely review her tests and assignments completed in
very other word. class. Gisela's parents agreed to do so.
'en enough time, A second meeting occurred 2 months later. The school psychologist,
me her reading. Mrs. Dartil, and Gisela's teacher, Mrs. Martinez, reviewed Gisela's progress and
e reading group. repeated their recommendation for an evaluation. Gisela's school performance
ms related to her was essentially unchanged and Mr. and Mrs. Garcia were now more aware of their
'esented orally, as daughter's daily academic problems. The parents remained reluctant about testing,
writing the word but following some private discussions over the next 2 weeks, finally relented and
tudy new words gave their consent. Mrs. Dartil immediately scheduled a comprehensive testing
g the week. The session for Gisela with her initial intent to discover whether the child had a
during the week learning disorder or disability.
ral spelling tests,
r failures on rote
ASSESSMENT
;pelling problems
cause the teacher A diagnosis of learning disorder is pertinent when one's "achievement on
lab projects (e.g., individually administered, standardized tests in reading, mathematics, or written
'hese assignments expression is substantially below that expected for age, schooling, and level of
Ld writing. Gisela intelligence" [American Psychiatric Association (APA), 2000, p. 49]. "Substantially
d her interest and below" often means a discrepancy of more than two standard deviations between
levels of achievement and intelligence. Learning problems must significantly
T at an early first­ interfere with academic or daily functioning. Gisela's learning difficulties certainly
i several strengths interfered with her academic functioning: she had grades of F in reading, spelling,
a keen interest in and math, and a D in science (though she did receive A grades in music and art).
;ths also included The DSM-IV-TR divides learning disorders into those associated with reading,
t liked children in mathematics, and written expression. Gisela seemed to have learning disorders in
aid Gisela seemed reading and written expression.
oolwork. Learning disorders do not apply if a child's academic problems are primarily
vior. The teacher due to "normal variations in academic attainment ... lack of opportunity, poor
ltion but was not teaching, or cultural factors" (APA, 2000, p. 51). Learning disorders do not apply
or impolite. Gisela if a person has a sensory deficit, such as visual problems, but may apply iflearning
ask. Mrs. Martinez problems are clearly in excess of that deficit. Mr. and Mrs. Garcia argued that
nely disorganized. Gisela's "problems" came from poor teaching in particular and a poorly funded
ts. She also had no school district in general. They did not think Gisela had a learning disorder. This
une. issue is obviously a delicate one when deciding if a diagnosis oflearning disorder
:eports well. They applies to a child who fails classes.
)lem, blaming the Those who evaluate children with possible learning disorders must consider
?; practices." They some key points. First, a child's learning problems must be examined in detail
; refused to release because the problems can take many forms such as poor organization, inability to
also said Gisela stay on task, and perceptual problems. Mrs. Martinez mentioned several problems
ley supervised her. that prevented Gisela from doing well in school. Second, specific deficits such as
d that, overall, she word decoding problems could have wide-ranging consequences for general
reading or academic achievement. Third, an assessor should carefully consider
78 C H A PT E R 7

expectations and concerns of parents and teachers. This was especially pertinent to
Gisela given her parents' reservations about her school.
Fourth, an assessor should remember that cognitive and behavioral char­
acteristics influence one another. Language deficits may predispose a child to
social withdrawal. Gisela's ongoing academic problems may negatively affect
her self-esteem. Fifth, environmental variables such as sociocultural factors must
be considered. These factors could affect a child's school-based motivation,
competitiveness, attitudes, or achievement orientation. Finally, the presence of
biological factors should be considered. An initial assessment oflearning disorder
may include the Dyslexia Screening Instrument* and the following sample items
(Coon, Waguespack, & Polk, 1994):
• Poor sequencing skills
• Poor organization of composition (events are not in chronological order or
any discernible order of organization)
• H~s trouble with the alphabet (learning and/or saying)
Mrs. Dartil began her assessment of Gisela using the Wechsler Intelligence
Scale for Children (Wechsler, 2003). Cognitive functioning is a central focus
when assessing a child with a possible learning disability. One should note wide
discrepancies between intelligence test scores and achievement test scores. Gisela
received an IQ score of 104, which placed her in the normal or average range.
Mrs. Dartil also administered the Wide Range Achievement Test-4 (Wilkinson &
Robertson, 2006) to identifY weaknesses in Gisela's academic math, reading, and
spelling skills. Gisela's standard scores were only 88 for math, 68 for reading, and
60 for spelling. Gisela's intelligence and achievement levels were therefore quite
different - she was not performing to her potential.
Some consider discrepancies between intelligence test scores and achievement
test scores to be invalid indicators of learning disabilities. Some researchers suggest
that reading and listening comprehension should be the focus of assessment (Lyon,
Fletcher, & Barnes, 2003). Tests for comprehension should center on a child's
absorption of information from a particular passage, inferences made from the
passage, and the child's use of information from her background knowledge.
Another problem with intelligence and achievement tests is that they do not
identifY a child's specific deficits or problems. Mrs. Dartil re-interviewed Gisela's
parents and teacher and examined Gisela's schoolwork and classroom behavior in
more detail. Mr. and Mrs. Garcia said Gisela was always a normal child, talking and
walking at appropriate ages and interested in others. They did admit that Gisela
struggled somewhat in first grade, but said her teacher claimed nothing was
seriously wrong. No one complained of language problems either. These
assertions from the first-grade teacher led Mr. and Mrs. Garcia to their current
position that nothing was wrong with their daughter. Mrs. Garcia conceded,
however, that Gisela was a slow reader who had trouble identifYing certain words.

* Dyslexia Screening 11tS1",menl. Copyright © 1994 by Harcourt Assessment, Inc. Reproduced with pennission. All rights
reserved.
 LEA R N I N G DIS A B I LIT Y 79

:cially pertinent to Both were surprised that Gisela could not read by the end of first grade, but
assumed she was a late bloomer. Both reaffirmed that Gisela was a well-behaved
behavioral char­ child and both insisted they were higWy motivated to help her academically.
iispose a child to Mrs. Dartil collected copies ofGisela's written classroom work and watched her
negatively affect in the classroom. She noticed that Gisela often took a long time to finish reading
Itural factors must and writing assignments and lost points as a result. Her performance improved,
lased motivation, however, when allowed enough time. Gisela was easily distracted and fidgety and
y, the presence of these behaviors interfered with her on-task behavior. Gisela's work performance
]earning disorder did improve, however, when she was isolated from the rest of the class. Finally, the
ling sample items school psychologist saw that Gisela's written work had several problems such as
slow, compressed, and unevenly drawn writing. Gisela spent much time copying
and recopying her work, a practice that sometimes frustrated her.
The school psychologist then spoke with Gisela's teacher in more depth.
1010gical order or Mrs. Martinez thought Gisela had a "processing deficit" or trouble assimilating and
integrating incoming information. She based her assumption on Gisela's struggles
with words presented visually. Gisela had problems remembering spelling words
:hsler Intelligence she studied from a book. However, Gisela did better when the teacher emphasized
learning through the auditory sense such as saying a word, spelling it aloud, and
is a central focus
writing the word on paper. Gisela had no visual sensory deficits, so perceptual or
should note wide
test scores. Gisela linguistic processing problems may have been responsible for her struggles.
The school psychologist also found Gisela's motivation to be good despite her
or average range.
academic setbacks. Gisela said she was interested in extra help to improve her
st-4 (Wilkinson &
grades and especially her reading. When asked about her fidgeting and moving
oath, reading, and
around, Gisela said she "felt nervous" and sometimes bored in class. She did feel
8 for reading, and
she could control herself, however. Mrs. Dartil saw that Gisela concentrated better
Te therefore quite
and moved less when a task was new or particularly interesting. Mrs. Dartil
, and achievement concluded from her assessment that Gisela did have a moderate learning disorder
for reading and written expression. She also conveyed to the teacher and to
~esearchers suggest
"assessment (Lyon, Mr. and Mrs. Garcia, however, that she could address the problems with steps
described later.
enter on a child's
~s made from the
d knowledge.
s that they do not
terviewed Gisela's RISK FACTORS AND MAINTAINING VARIABLES
;room behavior in
I child, talking and Cognitive deficits in learning disorders likely relate to different neurological
admit that Gisela problems. These cognitive deficits may include (1) perceptual problems, such as
med nothing was trouble distinguishing letters and words, and/or (2) linguistic processing problems,
ms either. These such as trouble organizing speech sounds to form words.
a to their current Cognitive deficits or specific linguistic processing difficulties in children with
Garcia conceded, reading problems may relate to abnormalities of the cerebellum and temporal lobe
'ing certain words. (Eckert, 2004; Silani et al., 2005). Disruptions in neural networks may also lead to
a learning disability (Ramus, 2004). Twin data indicate that reading disorder has a
moderate to strong genetic influence (Hawke, Wadsworth, & DeFries, 2006).
,ith pennission. All rights Reading difficulties may relate to changes on chromosomes 1, 2, 3, 6, 11, 13, 15,
and 18 (Shastry, 2007).
80 C HAPTE R 7

Changes in the brain's left hemisphere and planum temporale may explain
core defICits related to reading problems (Paul, Batt, Heim, Eulitz, & Elbert,
2006). These core deficits, which are independent of intelligence, often include
trouble decoding and reading single words. Good readers can recognize single
words quickly as they read. Children with reading disabilities identify words more
slowly and this lack of speed interferes with their integration and comprehension
of the overall material (Shaywitz & Shaywitz, 2005). Whole-language learning, in
which children figure out a word by looking at the context of the sentence, may
thus be ineffective for this population.
Children with reading disabilities have trouble recognizing words as they
read. Word recognition deficits may relate to memory problems as well as
language or phonological deficiencies, Children with reading problems have
trouble putting together various phonemes, or basic sound units, that comprise a
word (e.g., p honemes " sp," "ee,
" an d" ch" compnse . t h e word " speec h") . Th'IS
inability may affect spelling as well.
Gisela's reading and spelling problems did involve trouble with single-word
identification. Her academic problems might be due to changes in the left
hemisphere and her academic strengths in music and art might be due to a more
dominant right hemisphere. Gisela was left-handed as well, which suggests right
brain dominance. She did not receive medical or neurological tests, however.
Gisela's reading problems may have been due to memory and phonological
processing deficits. She clearly had trouble remembering words she supposedly
learned before and often failed to connect sound units to make up a word. Gisela
became frustrated when Mrs. Martinez asked the class to sound out a word such
as "poisonous." Mrs. Martinez thought Gisela's troubles were simply due to
inattention from fidgeting and twirling around. Inattention and phonological
awareness, or knowing how to use phonemes to recognize words and process
information, are largely independent of one another, however (Lyon et al., 2003).
Gisela clearly had learning problems beyond minor behavior problems or symp­
toms of attention deficit/hyperactivity disorder.
What about Gisela's writing problems? Children with learning disabilities
tend to (1) write less, (2) have less organized ideas and transitions in their writing,
(3) show less goal orientation, and (4) inadequately monitor their work for
appropriate spelling and grammar (Berninger, Nielsen, Abbott, Wijsman, &
Raskind, 2008). Many children with writing and spelling difficulties also have
trouble producing letters, organizing finger movements, mapping out written
words phonologically, and integrating visual-motor stimuli.
Gisela certainly had trouble integrating the phonological structure of words.
She often became frustrated and did not check her work properly for mistakes.
Her teacher also questioned Gisela's ability to coordinate visual and motor
movements. Gisela did show some characteristics of good readers and spellers,
however. She was goal-oriented, had no obvious trouble with finger movements,
and produced letters without difficulty (albeit slowly and in a compressed
manner). Patterns such as Gisela's are not unusual in children with learning
disabilities and attest to the enormous heterogeneity or variety of symptoms often
seen in this population.
 LEA R N I N G DIS A B I L J T Y 81

ale may explain Gisela did not have many problems with math (dyscalculia), but the etiology
:ulitz, & Elbert, of this learning disorder is briefly presented here. Children with dyscalculia often
e, often include have trouble enumerating, manipulating amounts, understanding mathematical'
recognize single concepts, doing computations, and reading, writing, or naming mathematical
~tifY words more symbols. These children may have problems with visual-spatial and visual­
comprehension perceptual functioning, intelligence, verbal ability, and anxiety. Dyscalculia could
lage learning, in result from changes in the brain's left parietotemporal area (Shalev, 2004). Some
e sentence, may have linked dyscalculia to the structure of elementary textbooks in arithmetic.
These textbooks may lack attention to mastery of basic mathematical processes
~ words as they (Lyon et al., 2003).
tems as well as Learning disorders occur in many cases (25-80%) with attention deficit
problems have hyperactivity disorder (Voeller, 2004; Willcutt & Pennington, 2000). The causes
that comprise a of ADHD and learning disabilities may therefore overlap. Gisela was often
"speech"). This distracted and sometimes overactive when she fidgeted and twirled. Children with
learning disabilities may also have social, emotional, depressive, and conduct
lith single-word disorder-related problems. These problems are more variable - they did not apply
1ges in the left to Gisela - and may relate to the frustration and social rejection that sometimes
e due to a more comes with academic failure.
:h suggests right
sts, however.
nd phonological DEVELOPMENTAL ASPECTS
she supposedly
p a word. Gisela Children with reading disabilities (dyslexia) often have language or phonological
:mt a word such processing deficits. These deficits can occur as early as the first year of life. Delays
simply due to may occur in vocalizations such as babbling or cooing. Toddlers may show speech
ld phonological or language delay (Nelson, Nygren, Walker, & Panoscha, 2006). Comprehension
>rds and process problems can also occur at this time and may be present in children with trouble
ron et aI., 2003). understanding what others say. Behavior problems associated with language
lblems or symp­ difficulties also become more apparent at this time. Common behavior problems
include overactivity, impulsivity, inattention, aggression, and social withdrawal.
rning disabilities Mr. and Mrs. Garcia said Gisela was normal during her preschool years. This is
in their writing, not unusual and shows the difficulty in identifYing children with learning
their work for disabilities before they begin formal schooling. Mr. and Mrs. Garcia did say Gisela
tt, Wijsman, & was sometimes "scattered" and inattentive but they assumed this was part of her
:ulties also have general personality or normal for a preschooler. They also noticed Gisela's
ing out written constant fidgeting, but did not see this or her other behaviors as seriously
problematic.
lcture of words. Learning disabilities become more apparent during the initial school-age
rly for mistakes. period as children try to meet academic requirements. Kindergartners must listen
sual and motor to instructions, verbally express their desires, sit still, engage in basic writing, and
.ers and spellers, identifY letters among other tasks. Children with learning disabilities sometimes
.ger movements, have trouble with these areas and may act out or withdraw from others. Extra
1 a compressed practice and behavior modification programs can often help curtail these pro­
n with learning blems. If problems go undetected or if a child gets by, however, then learning
symptoms often disabilities will worsen during first and second grade. Language skills are strong
predictors oflater reading ability (Bishop & Snowling, 2004).
82 CHAPTER 7

Kindergarten was largely unremarkable for Gisela. Her teacher at the time said
Gisela took longer than most children to start a task and was easily distracted. She
had no language problems or trouble identifying letters, however. Gisela was
socially appropriate and well behaved but sought a lot of teacher attention
regarding class projects. Gisela's learning disabilities came into full bloom during
first and second grades, however, as she grappled with fornlal reading, writing,
spelling, and mathematical tasks. Phonological processing problems also became
more evident at this point, and Gisela had trouble decoding various words.
Reading problems are stable over time, reaching even into adulthood.
Reading problems may be stable because many children with learning disabilities
are not identified until discrepancies between intelligence and reading achieve­
ment become vel)' apparent. A delay in fmding a learning disability may therefore
delay treatment and add to the intransigence of the disorder. The stability of
learning disabilities may also result from various and uncoordinated interventions
by educators and others. This practice is harmful to those with severe learning
problems, so their troubles remain stable. Many children with learning disabilities
continue to experience academic failure, so their motivation for completing
schoolwork declines as well (Lyon et al., 2003). Decreased motivation obviously
harms their chances for achieving normal academic performance in the future.
Gisela had a mixture of good and bad prognostic signs. She was fortunate her
assessment and treatment occurred near the end of second grade. Earlier detection
and better parental cooperation might have led to faster treatment, however.
Gisela was also fortunate Mrs. Rankin, the school's special resource teacher, had
experience treating children with learning disabilities. Gisela's motivation was of
most concern, however. Mrs. Martinez, the second-grade teacher, said Gisela was
increasingly frustrated with her assignments. Her frustration may have been linked
to the difficulty of her assignments, which were more complex as the end of the
year approached. Gisela may also have been disappointed in having so few passing
grades despite several months of effort.
The prognosis for children with learning disabilities depends largely on the
severity of their speech and language impairments. Children with reading
problems often have continued trouble naming words quickly, recognizing basic
speech sounds, spelling, and reading symbols. Many eventually have anxiety and
antisocial behavior problems and few enroll in college (Beitchman et al., 2001).
Fortunately, Gisela's speech and language were relatively good. Better outcome
for those with learning disorders relates to higher intelligence and socioeconomic
status, early diagnosis and intervention, early language stimulation, fewer
comorbid diagnoses, and less severe disorder (Pratt & Patel, 2007).
Gisela's long-term prognosis is probably good because her intelligence is
normal, her learning difficulties were addressed in second grade, and significant
others in her life were motivated to improve her condition. Good outcomes may
not always be the case, however, in districts whose school psychologists are
overwhelmed by the number of children with learning disabilities. Many children
in these schools continue to struggle academically without help and drop out of
school prematurely. Long-term prognosis can therefore depend heavily on
whether extracurricular resources are available.
 LEARNING DISABILITY 83

T at the time said TREATMENT

y distracted. She
ever. Gisela was Treatment for children with learning disabilities usually involves several elements
eacher attention that require a coordinated effort among teachers, parents, and the student (Lyon
III bloom during et aI., 2003):
reading, writing,
1. Enrolling in academic remedial programs (sometimes in a part-time segregated
ems also became
classroom setting)
ous words.
into adulthood. 2. Improving metacognitive skills
Iming disabilities 3. Controlling associated behavior problems that interfere with learning
reading achieve­ 4. Increasing student motivation
lty may therefore
The stability of Academic remedial programs should emphasize many opportumties for
ted interventions success and devote extensive time to presenting information to students. These
1 severe learning programs must allow students to demonstrate their abilities in different areas and
aming disabilities practice various skills. Teachers should also provide frequent feedback and closely
for completing follow a child's progress in deficient academic areas (Taylor, Anselmo, Foreman,
lvation obviously Schatschneider, & Angelopoulos, 2000).
. in the future. Remedial programs must also be highly structured and directed. They should
was fortunate her emphasize concrete concepts, eliminate distractions, and progress systematically.
Earlier detection Programs that offer directed instruction for word decoding and recognition skills
tment, however. work well for those with reading problems (Lovett et aI., 2000). Remedial
Jrce teacher, had programs should also emphasize one-on-one teaching, mastery learning, generali­
lotivation was of zation of learned material, and incentives for academic performance. These
:r, said Gisela was programs should also target all of the child's learning deficiencies (Torgesen et aI.,
have been linked 2001).
as the end of the Mr. and Mrs. Garcia allowed Gisela to attend a special instruction class for
ng so few passing 1 hour each school day. They also agreed to help their daughter practice what she
learned during this class for 30 minutes each night. Mrs. Rankin, the special
ds largely on the resource teacher, began working with Gisela immediately because little time
en with reading remained in the school year. Mrs. Rankin decided to concentrate heavily on
recognizing basic Gisela's reading and decoding problems. This first involved a review of basic
have anxiety and concepts such as knowledge of different vowel and consonant phonemes,
nan et aI., 2001). phoneme combinations (e.g., "ou" and "sp") , and blending of phonics into
. Better outcome words. Only the last concept seemed particularly difficult for Gisela.
ld socioeconomic Following this basic review, which lasted 2 weeks, Mrs. Rankin moved
imulation, fewer quickly to mastery of reading material. She asked Gisela to review a particular
7). passage from a book and write down words she believed she would find
.er intelligence is troublesome. Gisela read the words on index cards and practiced identifYing the
:e, and significant phonemes of each word, blending the phonemes, and learning the definition of
)d outcomes may the word. Mrs. Rankin then read the passage as Gisela followed along with her
psychologists are finger or a pencil. Gisela then read the passage aloud to Mrs. Rankin and once to
es. Many children herself She repeated reading the passage until she made few errors (Gersten,
) and drop out of Fuchs, Williams, & Baker, 2001; Wong, 1996).
pend heavily on The teacher next addressed Gisela's spelling. Many vocabulary words can be
generated from reading exercises so Gisela took a certain number home to study.
84 CH APTE R 7

Some suggest that children in fIrSt and second grades take home 3 words and that
those in the third and fourth grades take home 4 words. The child studies the
assigned words and takes a spelling and vocabulary test on the words the next day.
The child must spell the word presented orally and write out its definition. Words
a child has mastered, both in spelling and in meaning, are prominently displayed to
enhance the student's self-esteem and give feedback on her academic progress
(Wong, 1996,2004).
Gisela found helpful the extra attention spent on reading and spelling, espe­
cially word decoding and recognition. Mrs. Rankin's rapport with Gisela was
good and this helped improve Gisela's mood in the classroom. Gisela initially
averaged about 11 errors per page read, but this quickly diminished to 2 errors per
page by the end of the school year. Unfortunately, the books chosen for Gisela to
read were at a late first-grade or early second-grade level. Mrs. Rankin thought
continued work over the summer might boost Gisela to a mid-second grade level
by the time she entered third grade.
Another goal of treatment for children with learning disabilities is enhancing
general metacognition. Metacognition refers to an awareness of one's thinking or
problem-solving processes. Metacognition applies especially to children with
dyscalculia who have trouble conceptualizing and solving arithmetic problems
abstractly (Garrett, Mazzocco, & Baker, 2006). Children learn to state a math
problem in words of their choosing, visualize the problem, predict an answer, and
self-monitor their computations.
Several metacognitive targets exist for children with dyslexia (Gersten et aI.,
2001; Wong, 1996):
• Increase awareness of the purpose of reading (i.e., for meaning, not simple
decoding)
• Improve knowledge of reading strategies (e.g., reading differently for pleasure
and for mastery of material)
• Develop sensitivity to important parts of a text (i.e., emphasis on relevant
information)
• Learn to detect inconsistencies in sentences
• Develop ability to resolve a comprehension problem (e.g., by using "look
back" strategies)
Metacognitive skills for reading also involve understanding the reading
process and why reading is important. Mrs. Rankin focused primarily on teaching
Gisela to monitor her comprehension and refer back to the reading material as
quickly and frequently as possible to enhance retention.
Another important goal of treatment for this population is to control behavior
problems that interfere with learning. This was not too pertinent to Gisela, whose
behaviors were limited to twirling, fidgeting, and minor distraction. Mrs. Martinez
gave feedback to Gisela when she was overactive or distracted and praised her
appropriate on-task behavior. More extensive procedures may be needed for
other children. Some children with learning disabilities also have symptoms of
hyperactivity, so stimulant medication may help them focus attention and curtail
 LEA R N I N G DIS A Bill T Y 85

3 words and that excess motor activity. Token economies with response cost may also be useful for
child studies the acting-out and disruptive behaviors.
,rds the next day. A key challenge when addressing children with learning disabilities is to
lefinition. Words maintain their motivation to complete homework and other assignments. Gisela's
~ntly displayed to parents placed her on a reward system that included weekend privileges for
;ademic progress completing and turning in a certain number of homework assignments (recall that
many of Gisela's earlier assignments were lost). This reward system was later
ld spelling, espe­ extended to include studying appropriately, organizing materials, and developing
with Gisela was typing skills so Gisela did not have to write so much.
1. Gisela initially Gisela's progress through the following summer was good, but she only attained
~d to 2 errors per a reading level equivalent to early second grade. Mrs. Rankin, Mrs. Martinez,
)sen for Gisela to and Mrs. Dartil discussed the possibility of retaining Gisela in second grade. Mr. and
Rankin thought Mrs. Garcia were strongly opposed to this, however, and agreed instead to increase
~cond grade level Gisela's reading instruction time with a resource teacher to 90 minutes per day. Both
parents promised to remain active in helping their daughter practice her academic
. ities is enhancing skills at home. This was largely successful and Gisela did reach a mid-third-grade
one's thinking or reading level by the end of the next school year.
o children with
hmetic problems
to state a math
::t an answer, and
DISCUSSION QUESTIONS
la (Gersten et al.,
1. A thorny issue in deciding on a diagnosis of learning disorder is discovering
whether the problem is internal to the child or a function of external factors
.ning, not simple such as poor teaching or inadequate schools. What infonnation would you
use to make this distinction? What criteria would you use to conclude that a
ently for pleasure child does not have a learning disorder or that the surrounding environment is
to blame for a child's academic problems? How would you address a case
hasis on relevant involving the latter situation?
2. Some claim that boys, who often have trouble with reading, receive many
tutorial and special resource programs at school. Girls, however, who often
have trouble with arithmetic, do not always receive the same type of
, by using "look
resources. Do you think this is true? Why or why not?
3. Boys generally receive more attention from classroom teachers than girls. Do
ling the reading you think this relates to gender differences seen in learning disorders? If so,
larily on teaching how can it be remedied? Explore possible benefits and disadvantages of
'ading material as gender-specific classrooms.
4. Are tests for intelligence culturally or racially biased? What evaluation process
. control behavior
could you use to eliminate all bias? Is this possible?
: to Gisela, whose
m. Mrs. Martinez 5. Assume Gisela's family was new to the United States. How would the
1 and praised her evaluation and treatment process mentioned here change, if at all?
y be needed for 6. How might use of new technology in computers and computer software
ave symptoms of affect future education in general and the prevalence and treatment of
~ntion and curtail learning disorders in particular?
86 CH APTE R 7

7. Gisela's parents resisted having their daughter evaluated. How might you
address parents like these in the case of a child with a possible learning
disorder?
8. How might you increase a child's self-confidence about her schoolwork?

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