Cognition of Children with Specific Learning Disability

Dyslexia, dysgraphia and dyscalculia are types of disorders among primary school children and collectively classified as specific learning disabilities or SpLD. This group of disorder manifest its symptoms by the existence of specific, persistent and significantly unexpected difficulties among children in the acquisition and use of reading or dyslexia, writing or dysgraphia and mathematical processes or dyscalculia despite good instruction, normal intelligence, high motivation and satisfactory socio-cultural adjustment.

Reliable research studies points to the fact that the SpLD disability is brought about by a dysfunction of the central nervous system. Children with learning problems associated with visual, audio and motor handicap, subnormal intelligence, emotional imbalance and those which are socio-cultural disadvantaged are not included in children with SpLD. The disability can be considered as an invisible handicap and are significant causes of poor academic performance of school children. Dyslexia or disability specifically related to reading is reported to affect 80% of learning-disabled children and considered to be a disorder of cognition or intellectual functioning (Shaywitz 1998).

The disorder is both familial and can be inherited. The author reported that based from linkage studies, the loci on chromosomes 6 and 15 are responsible for reading disability. Dyslexia is a learning disability manifested by deficits in phonemic process, phonological decoding, rapid naming of colored object drawings, difficulty in single word reading, vocabulary and spelling/writing of dictated words. Information among SpLD in Indian children is scanty. Children with SpLD and have not undergone remedial education known to alleviate cognitive problems exhibited discrepancy in their level of

intelligence, IQ and academic achievement. Quilford’s Structure of Intellect (SOI) Model has provided a convenient technique to measure cognition as part of the learning process (Guilford 1967). This study was conducted to determine whether cognition abilities (as defined by Guilford’s SOI Model) vary among Indian children with SpLD and having different levels of intelligence. Materials and Methods 1. Subjects, Methods and Procedures of the test The cross-sectional study was conducted in a clinic of a government-recognized medical college from January 2001 to March 2002.

Currently, SpLD can only be conclusively diagnosed in children nine years old and above. There is a dearth of reliable data concerning the prevalence of SpLD among Indian children. Children 9 years old and above referred to the clinic for complaints of poor academic performance and newly diagnosed by the clinic as having SpLD and had not yet subjected to remedial educations were enrolled for the study. Each child was assessed by a multidisciplinary team comprised of “Pediatrician, Counselor, Clinical Psychologist and Special Educator” (Subjects and methods, 4th par. ).

Audiometric and visual examinations of the children were done first to rule out hearing and visual problems and those found with non-corrective ailments were not qualified for the study. The Pediatrician is responsible for the detailed clinical history and thorough neurological examination of the children. The counselor ensured that the poor academic performance is not due to stress at home and school. If severe emotional disturbances, depression or attention deficit hyperactivity disorder (ADHD) was diagnosed, the children were automatically stricken out of the roster.

The standard intelligence test was conducted with the children by the Clinical Psychologist using the Wechsler Intelligence Scale for Children (WISC) to determine intellectual and cognitive ability of the children in relation to verbal, non-verbal and global IQ scores. The Special Educator aided by a locally developed Curriculum-Based Test, administer the test in specific areas of learning in the likes of basic learning skills, comprehensive reading and listening, oral and written expression and reasoning and mathematical computation. Based from this, if the child possess

an academic achievement of two years below the actual grade placement, the child will be considered having SpLD. In this study, the non-verbal performance of children with SpLD from WISC test was considered as their true level of intelligence due to the fact that children with SpLD normally perform poorly on verbal subtests compared to non-verbal subtests of the WISC. Based on the WISC test result, the students were grouped into three. First group is the average non-verbal intelligence group with non- verbal IQ of 90- 109, second group as bright normal non-verbal intelligence with non-verbal IQ of 110-119 and the

superior-non-verbal intelligence group with non-verbal IQ of 120-129. The study gained the approval of the Scientific and Ethics Committee of the medical school and all the subjects had signed informed consent from the parents. After the signing of the informed consent, one of the authors administered a battery of 13 cognition function tests (CFT’s) on each child individually, based on the Guilford Structure of Intellect (SOI) which assess the four areas of communication namely figural, symbolic, semantic and behavioral. A separate group of 125 non-disabled children whose age range from

9-14 years were also given CFTs to access their cognition level. The group was termed as the control group or the reference standard. To ensure that the test scores obtained were valid and not due to chance, each of the 13CFTs is comprised of sub-tests for the same specific cognition ability. The test subject was not allowed to answer another test without first completing the one administered or change answer of the one previously completed. There was no time limit for completion of the CFTs and a child has the liberty to leave a test without answering all its sub-tests if it was found too difficult.

About 60 to 90 minutes was consumed to complete the 13 CFTs. The data gathered underwent analysis based on the “Statistical Package for the Social Sciences, version 7. 5 for Windows (SPSS, Chicago, Illinois, USA)” (Subjects and methods, 13th par. ). The mean scores from the four areas of information from each of the three groups were compared between themselves using one-way ANOVA. The mean scores from each of the three study groups in the four areas of information were compared to the standard scores using Independent t-test with P value of <0. 05 considered as significant. 2.

Tests used a. Wechsler Intelligence Scale for Children (WISC) to determine the real intellectual and cognitive ability of the children in relation to verbal, non-verbal and global IQ scores. b. Quilford’s Structure of Intellect (SOI) Model, a convenient technique to measure cognition as part of the learning process. c. Cognitive Function Tests to assess cognitive level of intelligence in four areas four areas of communication namely figural, symbolic, semantic and behavioral. d. Statistical Package for the Social Sciences, version 7. 5 for Windows (SPSS, Chicago, Illinois, USA)

to test level of significance of the data collected. Result and Discussion Dyslexia, dysgraphia and dyscalculia diagnosis were done in 98% of the study subjects and revealed that 90. 5% of the subjects concomitantly has all the three types of SpLD present. A total of 216 children nine years old and above were referred to the clinic for poor academic performance. Diagnosis revealed that 42 were considered as slow learners having border line non-verbal IQ of 70-89. Fourteen exhibited mental retardation with non-verbal IQ of <69, four has correctible hearing and optical deficits, seven with

severe depression, 14 had language barrier and cannot understand fully well English as medium of instruction and 135 with SpLD. Of the 135 children, 19 exhibited comorbidity with ADHD, 2 with epilepsy and were stricken out of the sample roster. Of the 114 remaining sample children, 19 had no informed consent as their parents refused to sign it. The remaining 95 children served as the sample subjects for the study and all completed the CFTs. It can be inferred from the choice of sample subjects that those with emotional and non-correctible visual and audio problems and those with depression were

stricken out although diagnosed as having SpLD. The reason for this is to maintain the quality of the result in line with the hypothesis and objective that cognition ability of children is exclusively tied up with heredity and although other disabilities can affect cognition it has nothing to do with familial consideration of cognition potential. The four areas of information which were used as basis in assessing the cognition level of the test subjects is presented in Table 1. These four areas of information is enveloped in the cognition function tests (CFTs) given to each of the 95 subjects.

Of the 95 samples of study children, WISC test revealed that 45 had average-non- verbal intelligence, 35 belongs to bright normal non-verbal intelligence and 15 had superior non- verbal intelligence. The mean differences in CFT scores from the three study sample groups in four areas of information were not significant statistically when compared between themselves. Inferring from this statistical relationship, the data revealed that the four areas of information exert their influence as a compact group and the effect of one cannot be separated from the effect of the other. The

result of the CFTs is presented in Table 2. The average of the CFTs scores from the three study groups in the four cognition areas were significantly lower compared to the standard scores from normal children (Table 3). This information suggests that the existence of SpLD is a result of cognition ability inherited from the parents and the mind condition of SpLD children is not reactive to the learning stimulus being offered by the school while the mind of the normal children is fully reactive. This further points to the fact that a different teaching approach and strategy based on the teaching method

being used currently must be implemented to make the minds of the children with SpLD reactive. This may mean separating the SpLD children from the normal children and they should undergo remedial teaching using a different style. Table 2. Comparison of cognition function tests among the three groups Table 3. CFT scores from the reference group __________________________________________ Figural information 25. 14 ± 3. 36 Symbolic information 27. 36 ± 4. 17 Semantic information 28. 30 ± 4. 29 Behavioral information 7. 54 ± 1. 46 ___________________________________________

The result indicated that children with SpLD whether they were classified as average, normally bright and with superior non- verbal intelligence have similar range of abilities with respect to cognition in the four areas of information processing. However, their scores in all of the four areas of cognition were significantly lower than those of the normal children. This provided proof that cognition capacity is controlled by genes and being so has a great potential to be transferred from the parents to the offsprings. The exclusion of children with SpLD but with non-corrective audio and visual impairment,

those who were subjected to great chronic distress and those with ADHD made the result of CFTs conclusive that cognitive ability is heritable. This is for the reason that the possible effect of those visual, audio and behavioral disorders were eliminated from the result as a result of their non-inclusion in the study thereby resulting to absolute purity of outcome related to the objective of the study. The significantly lower cognition abilities of SpLD children vise the normal ones with respect to immediate awareness, comprehension and recognition of stimuli provided proof why these children face

significant and long lasting difficulties in understanding the use of reading, writing and mathematics. The information from this study can aid the educators towards developing specialized teaching strategies to ease the difficulties being experienced by these children. SpLD is not just a disability that is school- related but rather a lifetime and personal disability that can adversely affect self-image, peer, family and social relations. It was proven from the study that cognition ability is hereditary and a dysfunction of the central nervous system. The study also provided proof that regardless of non-verbal intelligence classification,

children with SpLD possess the same level of cognitive ability although significantly lower than normal children’s cognitive ability. This means that SpLD children with the absence of corrective measures is underperforming their academic achievement. Something must be done to make their cognition more reactive to learning stimulus. This means that the academic performance of SpLD children can be enhanced by intervention using specialized teaching methods. In so doing, the discrepancy that exist between the SpLD and normal children can be placed in equal and level playing field with normal

children with the help of special teaching modules designed to develop the disabled and slow comprehension process among children with SpLD. That is in the presumption that the disability was discovered earlier and the remedial action was implemented. The remedial action of providing an specialized lesson module is the only proven way we can help the SpLD children. The disability will be a lifetime burden if corrective measures were not done at early age. As an educator, it is very satisfying to note and it gives a feeling of high achievement knowing that a child was saved from a life doomed to be

of lesser importance due to heredity to a more productive life with great potential for success. Reference Guilford JP (Editor). The nature of human intelligence. 1st edn. New York: McGraw-Hill; 1967. Karande, S. , Sawant, S. , Kulkarni, M. , Galvanka, R P, Sholapurwala, R. (2005). Comparison of cognition abilities between groups of children with specific learning disability having average, bright normal and superior nonverbal intelligence. Indian Journal of Medical Sciences, 59, 95-103. Shaywitz, S. E. (1998). Dyslexia. New England Journal of Medicine, 338, 307-312.

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