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Learning Preferences and
Styles
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Learning preferences and learning styles refer to an individual’s
preferred modes of and different approaches to learning based on
their individual strengths and weaknesses. Although various learning
styles exist, the most commonly referenced types are auditory, visual,
and kinesthetic (learning by doing). Ideally, students learn effectively
using a combination of these styles. Those who do not are at a strong
disadvantage if their school teaches in a manner that does not match
their individual learning style. The use of learning style profiles
to guide instruction requires careful monitoring of a student’s
progress and learning effectiveness so that adjustments can be made
as appropriate. Inventories and style indicators are useful as only
guides; their reliability and benefit can be determined only through
continual evaluation of a student’s performance. The intent
of identifying learning styles or preferences is to enable a student to
intake and output information in ways that are most comfortable
and successful.
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Underachievement refers to lower academic performance than expected
based on abilities (IQ). It is reflected by poor grades and schoolwork
production. It may also be accompanied by lower than expected performance
on tests of academic achievement. Possible causes of underachievement
include attention deficit hyperactivity disorder (ADHD), learning
style and other educational issues, emotional and behavioral disorders,
family and social factors, and engagement in high-risk behaviors
such as drugs and delinquency. Underachievement can lead to or reflect
poor self-esteem. Unaddressed, this may lead to school failure and dropout.
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Learning Disabilities
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The most common definition of a learning disability is a significant
to severe (1.5–2 standard deviation) discrepancy between
a child’s abilities (as measured by an individually administered
IQ test) and the child’s achievement (as measured by individually
administered tests of achievement in reading, written expression, and
mathematics).2 This model is often used to determine
who qualifies for services in schools, and in some school systems,
a child needs a discrepancy of 2 standard deviations before qualifying
for services. The problems with this model are that few characteristics, such
as memory or phonologic awareness (sensitivity to the sound structure
of language), differentiate poor readers with discrepancies from
those without discrepancies.1 In addition, the
amount of discrepancy is not necessarily related to the severity
of the learning disability3 and does not predict
the reading level of a child over time in response to a reading
intervention4 or how a child will respond to a
given intervention.5 Using a discrepancy model,
children with low average IQs and commensurate low average achievement
(both 1.5 to 2 standard deviations from the mean) would not qualify
for services; and there is no evidence that they would not benefit
from educational services similar to those with normal IQs.
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The Individuals with Disabilities Educational Act (IDEA) defines
a specific learning disability as a disorder in one or more of the
basic psychological processes involved in understanding or in using
language (spoken or written), which may manifest itself in an imperfect ability
to listen, think, speak, read, write, spell, or to do mathematical
calculations. This definition of learning disabilities includes
such conditions as “perceptual handicaps, brain injury,
minimal brain dysfunction, dyslexia, and developmental aphasia.”6 Federal
regulations recognize learning disabilities in oral expression,
listening comprehension, written expression, reading comprehension,
mathematics calculation, and mathematics reasoning that are not
caused by a sensory or motor handicap; mental retardation; emotional
disturbance; or social, cultural, and economic factors.
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The Diagnostic and Statistical Manual of Mental Disorders:
DSM-IV-TR7 describes 4 categories of learning
disabilities: reading disorder, mathematics disorder, disorder of
written expression and learning disability not otherwise specified.
According to the DSM-IV-TR, learning disorders are diagnosed when the
individual’s achievement on individually administered,
standardized tests in reading, mathematics, or written expression
is substantially below expectation for age, appropriate educational
experiences, and level of intelligence. The learning problems need
to significantly interfere with academic achievement or activities
of daily living that require reading, mathematical, or writing skills.
If a sensory deficit (such as vision or hearing impairment) is present,
the learning difficulties must be in excess of those usually associated
with the deficit. Table 85-1 reviews a number
of described learning disabilities.
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Learning disorders may persist into adult life. In spite of these
discrete definitions, there is a great deal of heterogeneity and
overlap in learning disabilities. For example, there is little evidence
for a learning disability in written expression in the absence of
other learning disabilities. Coexisting conditions such as reading disability
with attention deficit hyperactivity disorder is more impairing
than reading disability in isolation.
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Nonverbal Learning Disabilities
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Nonverbal learning disorder (NLD) is characterized by a specific
pattern of relative strengths and deficits in academic skills. Reading
and spelling skills may be well developed in association with weaknesses
in social areas. Children with NLD make more efficient use of verbal than
nonverbal information in social situations and thus have difficulty
reading social cues. In some cases, it may be difficult to differentiate NLD
from Asperger disorder (see Chapter 92). In
children under 4 years old who have NLD, psychosocial functioning
can be relatively typical or involve only mild deficits. Following this
period, children with NLD may develop externalizing behavior and
may present with hyperactivity and inattention. They are frequently
perceived as acting out and hyperactive and are commonly identified
by their teachers as overtalkative, troublemakers, or behavior problems.
With advancing years, activity level can normalize and even become
hypoactive. By older childhood and early adolescence, the typical
pattern of psychopathology is internalizing in nature, characterized
by withdrawal, anxiety, depression, atypical behaviors, and social
skills deficits. Their interactions with other children are stereotypical,
and their facial expressions lack affect. This stereotypical behavior
is often accompanied by deficits in social perception, judgment,
and interaction skills. The neuropsychological assets and deficits
that characterize NLD are evident in a wide variety of pediatric neurological
diseases and disorders such as Asperger disorder, early shunted
hydrocephalus, velocardiofacial syndrome, and Williams syndrome.
Children with NLD are particularly prone to serious psychosocial
dysfunction over the course of their development compared to children
whose learning disabilities are a result of phonologic processing.
NLDs are less prevalent than language-based learning disorders (0.1%–1.0% of
the general population).8,9