American Medical Association Family Medical Guide - American Medical Association [191]
Learning Disabilities
Not all children develop skills at the same rate. Although some children may be slower than others of the same age to develop certain skills, they usually catch up eventually. A learning disability is a significant gap between a person’s intelligence and the skills he or she has achieved at each age. Learning disabilities are neurological disorders in which the brain is unable to correctly process, use, or retrieve information that a person reads or hears.
Although the exact cause of learning disabilities is not known, doctors think that they may be caused by disturbances in brain development before birth. Factors that may affect brain development include genes, fetal exposure to drugs (such as alcohol and tobacco) used by a woman during pregnancy, or complications during pregnancy (including preterm delivery; see page 529) that can affect the fetus’s developing brain. Exposure to environmental toxins such as lead (see page 425) after birth also can contribute to the development of learning disabilities.
Learning disabilities can affect people of all ages and backgrounds. Many people with learning disabilities are of average or above-average intelligence. The symptoms of learning disabilities can vary greatly from one person to another, and some people have more than one learning disability. Some children with a learning disability also may have an attention deficit disorder (see page 730).
If you are concerned about your child’s development or suspect that he or she may have a learning disability, talk to your pediatrician and to teachers (if your child is school age or about to enter school). Federal law guarantees to children who have a learning disability a public education specifically designed to their needs. The earlier a learning disability is diagnosed, the more likely a child is to reach his or her intellectual and academic potential. If your child’s school doesn’t notice a delay in your child’s development, but you do, request an outside evaluation. It is essential to get an accurate diagnosis. If your child is not in school yet, call administrators at the school he or she will attend or the district office to find out what early intervention programs are available for your child.
Developmental Speech and Language Disorders
Developmental speech and language disorders can affect the way a person speaks or understands what is being said. Some children outgrow developmental speech and language disorders. However, in some cases such a disorder may be a sign of a future learning disability. Some subcategories of speech and language disorders include:
Developmental articulation disorders
Developmental articulation disorders are common. A child with a developmental articulation disorder may have difficulty controlling his or her rate of speech or pronouncing certain letters or letter combinations. If diagnosed and treated early, developmental articulation disorders can often be corrected, although children usually outgrow them.
Developmental expressive language disorders
Children who have a developmental expressive language disorder may have difficulty expressing themselves in speech. The child often knows what he or she wants to say but is not able to convert the thoughts into words. Children who have a developmental expressive language disorder may have difficulty answering simple questions or may not be able to combine words to form sentences.
Developmental receptive language disorders
A child who has a developmental receptive language disorder may have difficulty understanding certain aspects of speech because the brain does not recognize certain sounds or words. Children who have a developmental receptive language disorder may seem inattentive, may not follow directions, or may not respond to their name when