Learning Disabilities

Overview

Learning disabilities affect how a person learns to read, write, speak, do math, and handle other similar tasks. They are related to differences in the brain, most often in how it functions, but also sometimes in its structure. These differences affect the way the brain processes information.

Some of the most common learning disabilities are:

• Dyslexia: People with dyslexia have problems with reading words accurately and with ease (sometimes called “fluency”) and may have a hard time spelling, understanding sentences, and recognizing words they already know.
• Dysgraphia: People with dysgraphia have problems with their handwriting. They may have trouble forming letters, writing within a defined space, and writing down their thoughts.
• Dyscalculia: People with this math learning disability may have difficulty understanding arithmetic concepts and doing addition, multiplication, and measuring.

There are many different types of learning disabilities, and some people may have more than one. So it is hard to estimate how many people might have learning disabilities.

Having a learning disability is not related to intelligence. It simply means that the person’s brain works differently from others. In many cases, there are interventions that can help a person with learning disabilities improve their reading, writing, speaking, and calculation skills.

Learning disabilities are often discovered once a child is in school and has learning difficulties that do not improve over time. A person can have more than one learning disability. Learning disabilities last a person’s entire life, but a person can still be successful with the right educational supports.

A learning disability is different from learning problems caused by intellectual and developmental disabilities, or emotional, vision, hearing, or motor skills problems.

Different groups may define “learning disability” differently. It often depends on the focus of the organization. You can read more at the U.S. Department of Education, which provides statutes, regulations, and policies on the Individuals with Disabilities Education Act, and at the Learning Disabilities Association of America.

Signs and Symptoms

Many children have trouble reading, writing, or performing other learning-related tasks at some point. This does not mean they have a learning disability. A child with a learning disability often has several related signs, and they do not go away or get better over time. The signs of learning disabilities vary from person to person.

These signs alone are not enough to determine that a person has a learning disability. Only a professional can diagnose a learning disability.

Common general signs that a person may have learning disabilities include:

• Problems reading and/or writing
• Problems with math
• Poor memory
• Problems paying attention
• Trouble following directions
• Clumsiness
• Trouble telling time
• Problems staying organized

A child with a learning disability may also show one or more of the following:

• “Acting out” in school or social situations
• Difficulty staying focused; being easily distracted
• Difficulty saying a word correctly out loud or expressing thoughts
• Problems with school performance from week to week or day to day
• Speaking like a younger child; using short, simple phrases; or leaving out words in sentences
• Having a hard time listening
• Problems dealing with changes in schedule or situations
• Problems understanding words or concepts

Each learning disability has its own signs, and a person with a particular disability may not have all the signs of that disability.

Reading Disorders

Reading disorders occur when a person has trouble reading words or understanding what they read. Dyslexia is the most well-known reading disorder, but it is not the only one.

Dyslexia

People with dyslexia usually have trouble making the connection between letters and sounds and with spelling and recognizing words. Other signs may include:

• Having a hard time understanding what others are saying
• Difficulty organizing written and spoken language
• Delay in being able to speak
• Difficulty expressing thoughts or feelings
• Difficulty learning new words (vocabulary), either while reading or hearing
• Trouble learning foreign languages
• Difficulty learning songs and rhymes
• Slow rate of reading, both silently and out loud
• Giving up on longer reading tasks
• Difficulty understanding questions and following directions
• Poor spelling
• Problems remembering numbers in sequence (for example, telephone numbers and addresses)

Hyperlexia

Hyperlexia is a condition where people have advanced reading skills but may have problems understanding what is read or spoken aloud. They may also have cognitive or social problems. Hyperlexia may be associated with autism spectrum disorders, but not all children with autism spectrum disorders will have hyperlexia, and vice versa.

Other Reading Impairments

Reading disorders can also involve problems with specific skills:

• Word decoding: People who have difficulty sounding out written words struggle to match letters to their proper sounds.
• Fluency: People who lack fluency have difficulty reading quickly, accurately, and with proper expression (if reading aloud).
• Poor reading comprehension: People with poor reading comprehension have trouble understanding what they read.

Dysgraphia

A child who has trouble writing or has very poor handwriting and does not outgrow it may have dysgraphia. This disorder may cause a child to be tense and twist awkwardly when holding a pen or pencil. Other signs may include:

• A strong dislike of writing and/or drawing
• Problems with grammar
• Trouble writing down ideas
• Losing energy or interest as soon as they start writing
• Trouble writing down thoughts in a logical sequence
• Saying words out loud while writing
• Leaving words unfinished or omitting them when writing sentences

Dyscalculia

Signs of dyscalculia include problems understanding basic arithmetic concepts, such as fractions, number lines, and positive and negative numbers. Other signs may include:

• Difficulty with math-related word problems
• Trouble making change in cash transactions
• Messiness in putting math problems on paper
• Trouble with logical sequences (for example, steps in math problems)
• Trouble understanding the time sequence of events
• Trouble describing math processes

Related Health Effects

Children with learning disabilities may be at greater risk for certain conditions compared with other children. Recognizing and treating these conditions can help a child be more successful.

Attention Deficit and Hyperactivity Disorder (ADHD)

Attention deficit and hyperactivity disorder (ADHD) occurs more frequently in children with learning disabilities compared to children without learning disabilities. A child with a learning disability who also has ADHD may be distracted easily and find it harder to concentrate.

Depression and Anxiety

A child with a learning disability may struggle with low self-esteem, frustration, worry, and other problems. Mental health professionals can help the child understand these feelings, learn ways to cope with them, and learn how to build healthy relationships.

Causes and Risk Factors

Researchers do not know all the possible causes of learning disabilities, but they have found a range of risk factors, such as:

• Family history: Learning disabilities tend to run in families, and children with a parent who has a learning disability are at higher risk.
• Genes: Research suggests that difficulty with reading may be linked to a person’s genes, meaning reading disorders can pass from one generation to the next. Some cases of reading disorders are associated with a change in genes that play a role in brain development.
• Prenatal factors: Factors that affect a fetus developing in the womb, such as alcohol or drug use, can put a child at higher risk for a learning problem or disability.
• Environmental factors: Poor nutrition or exposure to lead in water or in paint may play a role.
• Lack of early support: Young children who do not receive the support they need for their intellectual development may show signs of learning difficulties once they start school. For reading disorders, children’s experiences in the classroom or whether they were read to often as preschoolers can also play a significant role.
• Brain injury: Sometimes a person may acquire a learning disability later in life due to injury. Possible causes include dementia or a traumatic brain injury (TBI).

Prevention Guidance

Parents can reduce risk factors for learning disabilities by providing good nutrition and minimizing exposure to lead and other toxic substances. Parents can also support early learning by reading to their children; pointing out, describing, and naming objects in the environment; and counting with their children.

Diagnosis

Learning disabilities are often identified once a child is in school. The signs and symptoms likely start before school age, but they may not be detected until then. Special tests are required to make a diagnosis.

These signs alone are not enough to determine that a person has a learning disability. Only a professional can diagnose a learning disability.

School-Based Identification

Schools may use a process called “response to intervention” to help identify children with learning disabilities. This process usually involves:

• Monitoring all students’ progress closely to identify possible learning problems
• Providing children who are having problems with help on different levels, or tiers
• Moving children to tiers that provide increasing support if they do not show sufficient progress

Individual Evaluations

Students who are struggling in school can also have individual evaluations through the school or an external provider. An evaluation can:

• Identify whether a child has a learning disability.
• Determine a child’s eligibility under federal law for special education services.
• Help develop an individualized education plan (IEP) that outlines help for a child who qualifies for special education services.
• Establish benchmarks to measure the child’s progress.

A full evaluation for a learning disability includes:

• A medical exam, including a neurological exam, to rule out other possible causes of the child’s difficulties. These might include emotional disorders, intellectual and developmental disabilities, and brain diseases.
• Reviewing the child’s developmental, social, and school performance
• A discussion of family history
• Academic and psychological testing

Family history and a child’s history of response to instruction may also be involved.

Who Does the Evaluation

Usually, several specialists work as a team to do the evaluation. The team may include a psychologist, a special education expert, a speech-language pathologist, and other professionals. Many schools also have reading specialists who can help diagnose a reading disability.

School psychologists are trained in both education and psychology. They can help diagnose students with learning disabilities and help the students, parents, and teachers come up with plans to improve learning.

Speech-language pathologists are trained to diagnose and treat speech and language disorders. A speech-language pathologist can do a language evaluation and assess the child’s ability to organize their thoughts. The speech-language pathologist may evaluate the child’s learning skills, such as understanding directions, manipulating sounds, and reading and writing.

Special Considerations for Bilingual Children

Children being taught in a second language may show signs of learning problems or a learning disability. The learning disability assessment must consider whether a student is bilingual or a second language learner. For English-speaking children, the assessment should also be sensitive to differences that may be due to dialect (a form of a language that is specific to a region or group).

Treatment and Management

Learning disabilities have no cure, but early intervention can lessen their effects. People with learning disabilities can develop ways to cope with their disabilities. Getting help earlier increases the chance of success in school and later in life.

Experts can help a child learn skills by building on the child’s strengths and finding ways to compensate for the child’s weaknesses. Interventions vary depending on the nature and extent of the disability.

Interventions and accommodations for specific learning disabilities can be helpful.

Dyslexia

• Intensive teaching techniques: These include specific, step-by-step, and methodical approaches to teaching reading with the goal of improving both spoken and written language skills. These techniques are generally more intensive in terms of how often they occur and how long they last and often involve small group or one-on-one instruction.
• Classroom modifications: Teachers can give students with dyslexia extra time to finish tasks and provide audio for tests to allow the child to hear the questions instead of reading them.
• Use of technology: Children with dyslexia may benefit from listening to audio books or using word-processing programs.

Dysgraphia

• Specialized instruction: Interventions can increase hand strength and fine motor control help with letter formation. Specialized instruction can also help with spelling.
• Special tools: Teachers can offer oral exams, provide a note-taker, or allow the child to video reports instead of writing them. Computer software can help children produce written text.
• Use of technology: A child with dysgraphia can be taught to use word-processing programs, including those incorporating speech-to-text translation, or an audio recorder instead of writing by hand.
• Reducing the need for writing: Teachers can provide notes, outlines, and preprinted study sheets.

Dyscalculia

• Visual techniques: Teachers can draw pictures of word problems and show the student how to use colored pencils to differentiate parts of problems.
• Memory aids: Rhymes and music can help a child remember math concepts.
• Computers: A child with dyscalculia can use a computer for drills and practice.

Reading Disorders

Reading disorders cannot be “cured,” but with proper instruction, people with these disorders can overcome specific problems, learn to read, and improve fluency and comprehension. The best treatment strategy depends on the needs of the individual. In general, teachers with special training provide the most effective instruction, and the instruction should be intensive.

Specific instruction in the major parts of reading (phonemic awareness, phonics, fluency, vocabulary, and comprehension) is the best approach to teaching most children to read. Instruction should also be systematic (well-planned and consistent) and clear.

These skills are the foundation for understanding science, history, social studies, math, and the many other subjects students will study throughout their education.

Phonemic Awareness

Spoken words are made up of smaller pieces of sound, called phonemes. The English language has about 40 phonemes. When someone says a word, the sound comes out as one continuous stream. The brain must be able to separate the sound into pieces. For example, the word “bag” has three phonemes: /b/, /æ/, and /g/.

Understanding that words are made up of individual sounds is a key part of learning to read. An important skill that helps readers is called phonemic awareness, which refers to the ability to identify and manipulate (or work with) the individual sounds that make up a spoken word.

Phonemes make up spoken words, and words only make sense when these phonemes are combined in a particular order. Phonemic awareness can be taught and learned using activities such as rhyming games.

Another way to teach and learn this awareness is to work with single phonemes in spoken words, such as identifying the first sound in cat as /k/. Part of this learning is also realizing that a change to a single sound or phoneme can change the meaning of the word. For example, changing the /g/ in bag to a /t/ gives us the word bat, which has a different meaning from bag.

The Alphabetic Principle and Phonics

In alphabetic languages such as English, another part of learning to read is understanding that letters of the alphabet stand for sounds or phonemes. A phoneme can correspond to one letter or a group of letters. This knowledge is called the alphabetic principle.

When students use the letter-sound pairings to sound out printed words, it is called phonics. This requires learning to pair their knowledge of the sounds in words (phonemic awareness) with their skill at recognizing letters.

To better understand phonics, think about how you read a made-up word like “blit” or “fratchet.” Even though you don’t know the made-up word or what it means, you can read it by figuring out what sounds the letters make. Then you can sound it out and pronounce it.

Phonemic awareness and phonics skills help readers sound out new words.

Vocabulary

Knowing that a word has meaning is an important part of learning to read. The words we know are called our vocabulary.

Learning vocabulary starts very early in life. Infants and toddlers look at what you are talking about and say their first words to get what they need or want. As toddlers grow, they learn more words. By the time they start to sound out words to read, most children can recognize many of the words they are sounding out.

They know they have heard those words before, and they know what the words mean. This is why having a good vocabulary is so important for reading.

Fluency

As a reader continues to develop phonics skills, a specific reading skill called fluency also improves. Fluency goes beyond just pronouncing or knowing words. It includes many parts:

• Being able to read quickly
• Reading words accurately
• Saying words and sentences with feeling
• Stressing the right word or phrase so a sentence sounds natural and conveys the correct meaning

Comprehension

Understanding the information that words and sentences communicate is another important part of reading. This is called comprehension. Comprehension is the main goal of learning to read. There are many ways to improve comprehension:

• Building vocabulary: Readers with a bigger vocabulary can recognize more words and better understand the overall meaning of the text.
• Understanding the structure and organization of text: Readers who know what to expect can better comprehend what they are reading.
• Understanding different types of texts: Teachers can give students strategies or guidelines for understanding a newspaper, a fiction book, a textbook, or a menu.

Such strategies teach students to ask and answer questions about what they are reading, summarize paragraphs and stories, and draw conclusions from the information.

Living With a Learning Disability

Special Education Services

Children diagnosed with learning disabilities can receive special education services. The Individuals with Disabilities Education Act (IDEA) requires that public schools provide free special education supports to children with disabilities.

In most states, each child is entitled to these services beginning at age 3 and extending through high school or until age 21, whichever comes first. The rules of IDEA for each state are available from the Early Childhood Technical Assistance Center.

IDEA requires that children be taught in the least restrictive environment appropriate for them. This means the teaching environment should meet a child’s needs and skills while minimizing restrictions to typical learning experiences.

Individualized Education Program (IEP)

Children who qualify for special education services will receive an Individualized Education Program, or IEP. This personalized, written education plan:

• Lists goals for the child
• Specifies the services the child will receive
• Lists the specialists who will work with the child

To qualify for special education services, a child must be evaluated by the school system and meet federal and state guidelines.

Parents can also review these resources:

• The Center for Parent Information and Resources offers information about Parent Training and Information Centers and Community Parent Resource Centers.

Tips For Managing a Learning Disability as an Adult

• Be your own advocate: It is important to know and speak up for what you need. Understand your learning challenges, identify possible solutions, and ask for the resources that will allow you to reach your goals. In college, this might mean asking for additional time for taking tests or access to software that reads aloud to you.
• Ensure your surroundings support success: Work with your school or employer to create a supportive learning environment, such as access to software that will help you succeed now and in the future. Structuring your environment, whether through software design or office design, can help you perform at your potential.
• Take advantage of assistive technology: Several tools are now available to help people with learning disabilities. These include:
  • Audio books and software that reads text aloud, with adjustable reading speed
  • Computer tools that can read text aloud, help you articulate your thoughts, and provide structure to your writing
  • Writing systems that help generate sentences, paragraphs, and longer pieces of text

Find Clinical Trials

Clinical trials uncover better ways to prevent, diagnose, treat, and understand diseases and conditions. To ensure results apply to everyone, volunteers of all ages, sexes, and backgrounds, including both healthy individuals and those with specific medical conditions, are needed. Find clinical trials on learning disabilities.

Find Treatment

To qualify for special education services, a child must be evaluated by the school system and meet federal and state guidelines. Parents and caregivers can contact their school principal or special education coordinator to find out how to have their child evaluated.

Parents can also use these resources:

• The Center for Parent Information and Resources: The Network runs local Parent Centers that provide training and help for families of children with disabilities.
• The IDA Provider Directory lists International Dyslexia Association member professionals who have agreed to be a point of contact and referral source for various professional services, organized by state.
• The American Speech-Language-Hearing Association (ASHA) provides information about learning disabilities and offers a searchable list of professionals who specialize in speech-language problems.

Community Support

Many organizations provide information and resources for people with learning disabilities and their families:

• International Dyslexia Association (IDA)
• Learning Disabilities Association of America (LDA)
• National Center for Learning Disabilities (NCLD)
• Center for Parent Information and Resources (CPIR)
• Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)
• LD OnLine
• Understood

Note: This resource list is for informational purposes only. It is not comprehensive, and an organization’s inclusion does not constitute an endorsement by NIH.  

Research Information

The National Institutes of Health (NIH) is the largest public funder of biomedical research in the world. NIH invests most of its budget in medical research seeking to enhance life and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.

NIH and other federal agencies are studying what causes learning disabilities, how to identify them, and ways to treat them. NIH also studies typical learning processes and the effectiveness of different treatments for learning disabilities.

NIH research goals related to learning disabilities include:

• Understanding the role of the individual’s environment, genes, brain, behavior, and thinking and memory processes.
• Investigating the genetic and neurobiological foundations of these disabilities.
• Creating measurement tools to identify children at risk.
• Developing and evaluating prevention methods.
• Developing remediation and instructional approaches that promote learning.

Find NIH-funded research projects using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.