Journal of Postgraduate Medicine
 Open access journal indexed with Index Medicus & ISI's SCI  
Users online: 1416  
Home | Subscribe | Feedback | Login 
About Latest Articles Back-Issues Article Submission Resources Sections Etcetera Contact
 
  NAVIGATE Here 
  Search
 
 :: Next article
 :: Previous article 
 :: Table of Contents
  
 RESOURCE Links
 ::  Similar in PUBMED
 ::  Search Pubmed for
 ::  Search in Google Scholar for
 ::  Article in PDF (44 KB)
 ::  Citation Manager
 ::  Access Statistics
 ::  Reader Comments
 ::  Email Alert *
 ::  Add to My List *
* Registration required (free) 

  IN THIS Article
 ::  References

 Article Access Statistics
    Viewed13077    
    Printed126    
    Emailed5    
    PDF Downloaded388    
    Comments [Add]    
    Cited by others 5    

Recommend this journal


 


 
EDITORIAL
Year : 2008  |  Volume : 54  |  Issue : 2  |  Page : 75-77

Current challenges in managing specific learning disability in Indian children


Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai - 400 022, Maharashtra, India

Correspondence Address:
S Karande
Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai - 400 022, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0022-3859.40765

Rights and Permissions




How to cite this article:
Karande S. Current challenges in managing specific learning disability in Indian children. J Postgrad Med 2008;54:75-7

How to cite this URL:
Karande S. Current challenges in managing specific learning disability in Indian children. J Postgrad Med [serial online] 2008 [cited 2020 Oct 22];54:75-7. Available from: https://www.jpgmonline.com/text.asp?2008/54/2/75/40765


Specific learning disability (SpLD) is a group of neurodevelopmental disorders which manifest in childhood as persistent difficulties in learning to efficiently read ("dyslexia"), write ("dysgraphia"), or do simple mathematical calculations ("dyscalculia") despite normal intelligence, conventional schooling, intact hearing and vision, and adequate motivation and socio-cultural opportunity. [1],[2] Up to 5-10% of "seemingly normal" school children have this hidden disability. [1],[2] Dyslexia affects 80% of all those identified as learning-disabled. [1],[2] SpLD is now believed to be a result of functional problem with brain "wiring" rather than an anatomic problem and is genetically inherited. [1],[2]

These children present with academic difficulties such as reading slowly and incorrectly, skipping lines while reading aloud, making repeated spelling mistakes, untidy/illegible handwriting with poor sequencing, and inability to perform even simple additions and subtractions. [1],[2] They invariably fail to achieve school grades commensurate with their intellectual potential. [1],[2] Up to 15-20% of children with SpLD have associated attention-deficit hyperactivity disorder (ADHD) which is characterized by persistent hyperactivity, impulsivity and inattention and this co-morbidity further impairs their learning. [1],[3],[4] If SpLD remains undetected chronic poor school performance, class detention, and dropping out of school ensue. [1],[3],[4] This often leads to these children losing their self-esteem, developing withdrawn or aggressive behaviour, anxiety, depression and at times even anti-social behaviours. [1],[3],[4]

The cornerstone of treatment of SpLD is remedial ("special") education. [1],[5],[6] Because of the central nervous system's higher plasticity in early years this should ideally begin early, when the child is in primary school. [1],[5],[6] Using specific teaching strategies and teaching materials, the special educator formulates an Individual Educational Program to reduce or eliminate the child's deficiencies in specific learning areas of reading, writing and mathematics identified during the child's educational assessment. [5],[6] The child has to undergo remedial education sessions twice or thrice weekly for a few years to achieve academic competence. [5],[6] During these sessions the child with dyslexia undergoes systematic and highly structured training exercises to learn that words can be segmented into smaller units of sound ("phoneme awareness"), and that these sounds are linked with specific letters and letter patterns ("phonics"). [1],[4] The child also requires practice in reading stories; both to apply newly acquired decoding skills to reading words in context and to experience reading for meaning. [1] For dyscalculia, remediation involves rote learning of arithmetic facts, developing strategies for solving arithmetic exercises, and developing "number sense" or its access via symbolic information. [7],[8] However, even after adequate remedial education, subtle deficiencies in reading, writing, and mathematical abilities persist. [5],[7]

The management of SpLD in the more time-demanding setting of secondary school is based more on providing provisions ("accommodations") rather than remediation. [1] These provisions (for example, exemption from spelling mistakes, availing extra time for written tests, dropping a language subject, substituting algebra and geometry with lower grade of mathematics) serve to "level the play field" for these students so that their academic performance would now be commensurate with their intellectual ability. [1],[9] With remedial education and provisions most learning disabled children are able to continue their education in regular mainstream schools. [1],[3],[9]

It is important to remember that apart from SpLD, there are other causes for children to under perform, such as, chronic medical illnesses, borderline intelligence ("slow learners"), visual or hearing deficit, isolated ADHD, emotional problems, and poor socio-cultural home environment. [1],[3] However, a history of language delay, or of not attending to the sounds of words (trouble playing rhyming games with words, or confusing words that sound alike), along with a family history, are important red flags for SpLD in preschool children. [1] A conclusive diagnosis of SpLD should not be made until the child is in the third grade, or about 7-8 years old as some children are "normal late developers" and they on their own outgrow their learning problems (unlike SpLD which is a life-long disorder). [1],[3],[7] However, children in the age group of 5-7 years who show signs of SpLD on educational assessment should be considered as "at risk for SpLD" and remedial education started. [1],[3],[7]

In 1969, the United States of America government passed "The Children with Specific Learning Disabilities Act" which for the first time acknowledged that SpLD was a disability, and ensured that these children are entitled to "publicly funded" remedial education services and facility to avail the benefit of provisions in their school curriculum. [10] In 1977, this law was strengthened and these children were empowered with a "legal right to continue education in regular mainstream schools". This was done to protect them from discrimination in education. [10]

In the year 1996 the state government of Maharashtra was the first in India to formally grant children with SpLD the benefit of availing the necessary provisions to enable them to complete education in regular mainstream schools. [11] Initially these provisions were only given for the standard IX and Xexaminations; but subsequently in the year 2000 they were given from standard I to XII. [12] In a recent study carried out at our clinic, children with SpLD who availed the benefit of provisions showed a significant improvement in their academic performance at the Secondary School Certificate board examination. [9] Their mean total marks increased by 22% (from 41% before diagnosis of SpLD to 63% after availing provisions). [9]

In the year 2003 the government of Maharashtra extended the facility of provisions to college courses; and even seats were reserved for these adolescents in the physically handicapped category. [13] A recent judgment of the Mumbai High Court has clearly stated that in the state of Maharashtra it is mandatory for the school and college authorities to provide these provisions and denial would be regarded as contempt of court and the school/college authorities would be liable to prosecution. [14]

Following the good example set by the government of Maharashtra awareness about the needs of these children has grown in India. Since 1999, the national Educational Boards which conduct the Indian Certificate of Secondary Education and the Central Board of Secondary Education examinations have also formally granted children with SpLD the benefit of availing the necessary provisions. Subsequently, the state governments of Karnataka and Tamil Nadu have granted these provisions, and in the near future the state of Gujarat is to follow suit.

The recent Hindi movie Taare Zameen Par (" Stars on the Earth") has sensitively and accurately depicted the plight of an 8-year-old boy battling SpLD. The commercial success and critical acclaim of this movie has created a tremendous impact and will help sensitise viewers about this hidden disability. However, a lot needs to be done to ensure that every child with SpLD is detected and receives remedial education in our country. At present, there is a general lack of awareness about SpLD in India. Even in the mega cities like Mumbai, Chennai, Bangalore, New Delhi, and Kolkata, there are very few clinics for doing the psychoeducational testing for diagnosing SpLD; and there is a dearth of remedial teachers. In smaller towns and rural areas such clinics are non-existent.

Firstly, awareness of this hidden disability has to be increased and the topic of SpLD should be compulsorily taught to doctors, school teachers, counsellors, and general public (who are the future parents) during their undergraduate studies. It is known that a supportive home environment is one of the factors that can favourably determine the outcome of SpLD in a school-going child. [1],[3] Secondly, an evaluation for SpLD should be considered for all children presenting with learning problems in preschool/school. [1],[3] At present many children with SpLD studying in non-English (vernacular) medium schools, and especially in rural areas, are going undetected for non-availability of standardized psychological and educational tests. This lacunae needs to be corrected by developing standardized psychological and educational tests in all Indian languages. Also, few special educators are available to do the educational testing necessary for diagnosing SpLD. Many more universities in our country should start the undergraduate degree course, namely, B.Ed. (Special Education) and the postgraduate degree course, namely, M.Ed. (Special Education) for people wanting to become remedial teachers and special educators, respectively. Regular school teachers should be encouraged to take up the additional responsibility of becoming remedial teachers. Thirdly, SpLD should be recognised as a disability by the union government of India. For this advocacy groups will have to convince the policy makers to amend the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995 which is guided by the philosophy of promoting equality and participation of persons with disabilities and eliminating discriminations of all kinds. [15] At present the Act recognises visual impairment, hearing impairment, locomotor disability, mental retardation, leprosy-cured and mental illness to be disabilities. [15] The government of India since 2001 has launched the Sarva Shiksha Abhiyan ('Education for All' Movement) which is a comprehensive and integrated flagship program to attain universal elementary education in the country in a mission mode. [16] Launched in partnership with the state governments, the program aims to provide useful and relevant education to all children, including children with disabilities. [16] Once SpLD is recognised as a disability by the government of India, children with SpLD would be able to benefit significantly. Funds from the Sarva Shiksha Abhiyan would be available to set up detection centres in every city/ town/district headquarter and remediation centres in each school all over the country. At present, the facility of remedial education is still not available in many schools even in a mega-city like Mumbai and many parents cannot afford the services of special educators working in the private sector (one session costs about Rs. 250). [17]

Therefore, the problems faced by children with SpLD in our country can and have to be addressed at a national level on a war footing. We owe it to them, because education is one of the most important aspects of human resource development.

 
 :: References Top

1.Shaywitz SE. Dyslexia. N Engl J Med 1998;338:307-12.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2.Demonet JF, Taylor MJ, Chaix Y. Developmental dyslexia. Lancet 2004;363:1451-60.  Back to cited text no. 2    
3.Karande S, Kulkarni M. Poor school performance. Indian J Pediatr 2005;72:961-7.  Back to cited text no. 3    
4.Dakin KE. Educational assessment and remediation of learning disabilities. Semin Neurol 1991;11:42-9.  Back to cited text no. 4  [PUBMED]  
5.Alexander AW, Slinger-Constant AM. Current status of treatments for dyslexia: Critical review. J Child Neurol 2004;19:744-58.  Back to cited text no. 5  [PUBMED]  
6.McDonnell L, McLaughlin M, Morison P, editors. Educating one and all: students with disabilities and standards-based reform. Washington DC: National Academy Press; 1997.  Back to cited text no. 6    
7.Shalev RS. Developmental dyscalculia. J Child Neurol 2004;19:765-71.  Back to cited text no. 7  [PUBMED]  
8.von Aster MG, Shalev RS. Number development and developmental dyscalculia. Dev Med Child Neurol 2007;49:868-73.  Back to cited text no. 8  [PUBMED]  [FULLTEXT]
9.Kulkarni M, Karande S, Thadhani A, Maru H, Sholapurwala R. Educational provisions and learning disability. Indian J Pediatr 2006;73:789-93.  Back to cited text no. 9    
10.Shepherd MJ. History lessons. In : Kaufman AS, Kaufman NL, editors. Specific learning disabilities and difficulties in children and adolescents: Psychological assessment and evaluation. 1st ed. Cambridge: Cambridge University Press; 2001. p. 3-28.  Back to cited text no. 10    
11.Maharashtra State Education, Research and Training Center, Pune Circular No. 96-97/3334. July 1996. Available at http://www.mah.nic.in/msec/; accessed 2008, February 24.  Back to cited text no. 11    
12.Maharashtra Government School Education Department G.R. No. SSC 1099/(151/99) HSE-2. November 2000. Available at http://www.mah.nic.in/msec/; accessed 2008, February 24.  Back to cited text no. 12    
13.Directorate of Technical Education, Maharashtra State, Mumbai. Allocation and reservation of seats: reservation for physically handicapped candidates. Available at http://www.mkcl.biz/mbacet2008/frmSeatDistribution.aspx/; accessed 2008, April 4.  Back to cited text no. 13    
14.Anon. HC boost for dyslexic students. The Times of India, Mumbai 22 July 2006. Available at http://www.timesofindia.com articleshow/1789910.cms; accessed 2008, February 24.  Back to cited text no. 14    
15.Office of the Chief Commissioner for Persons with Disabilities. Ministry of Social Justice and Empowerment, Govt. of India. The Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995. Available at http://ccdisabilities.nic.in/Act%201.htm; accessed 2008, February 24.  Back to cited text no. 15    
16.Department of School Education and Literacy. Ministry of Human Resource Development, Govt. of India. Sarva Shiksha Abhiyan: A Programme for Universalization of Elementary Education, 2001. Available at http://ssa.nic.in/ssamission.asp; accessed 2008, April 4.  Back to cited text no. 16    
17.Karande S, Mehta V, Kulkarni M. Impact of an education program on parental knowledge of specific learning disability. Indian J Med Sci 2007;61:398-406.  Back to cited text no. 17  [PUBMED]  [FULLTEXT]



This article has been cited by
1 Child Poverty and Ecological Contexts of Deprivation and Well-being: A Critical Review of Budgeting and Social Policy in India
Keerty Nakray
Social Policy & Administration. 2015; 49(6): 752
[Pubmed] | [DOI]
2 Prevalence and Patterns of Learning Disabilities in School Children
Susanta Kumar Padhy,Sonu Goel,Shyam Sinder Das,Siddharth Sarkar,Vijaylaxmi Sharma,Mahima Panigrahi
The Indian Journal of Pediatrics. 2015;
[Pubmed] | [DOI]
3 The Proposed Changes for DSM-5 for SLD and ADHD: International Perspectives-Australia, Germany, Greece, India, Israel, Italy, Spain, Taiwan, United Kingdom, and United States
Al-Yagon, M. and Cavendish, W. and Cornoldi, C. and Fawcett, A.J. and Grünke, M. and Hung, L.-Y. and Jiménez, J.E. and Karande, S. and van Kraayenoord, C.E. and Lucangeli, D. and Margalit, M. and Montague, M. and Sholapurwala, R. and Sideridis, G. and Tressoldi, P.E. and Vio, C.
Journal of Learning Disabilities. 2013; 46(1): 58-72
[Pubmed]
4 Managing specific learning disability in schools in India
Sunil Karande, Rukhshana Sholapurwala, Madhuri Kulkarni
Indian Pediatrics. 2011; 48(7): 515
[VIEW] | [DOI]
5 Recollections of learning-disabled adolescents of their schooling experiences: A qualitative study
Karande, S., Mahajan, V., Kulkarni, M.
Indian Journal of Medical Sciences. 2009; 63(9): 382-391
[Pubmed]



 

Top
Print this article  Email this article
Previous article Next article
Online since 12th February '04
© 2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow