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Is Johnny's Primary Handicap a Learning Disability or ADHD?

 
Author: George Gallegos

Parents are usually worried by the report of learning problems and under performance in school by their child. Once learning accommodations and positive incentives have been informally introduced in the classroom, the next level of possible interventions to help a students academic performance in the classroom can become more complicated. The difficulty Johnny experiences in the classroom cannot be accurately understood without some amount of individualized evaluation primarily in the areas of intellectual ability, learning achievement, or his ability to regulate attention. Schools are more likely to refer a student for an ADHD evaluation prior to the initiation of a comprehensive learning evaluation completed by the schools special education team. Despite questions surrounding potential learning disabilities, schools often prefer to have the question of ADHD addressed prior to a decision to pursue special education testing for Johnny.

In the learned opinion of Russell Barkley (excerpts from his lecture on ADHD, San Francisco, June, 2000), up to 50% of children referred for ADHD also have learning disabilities. Although the incidence of these two conditions is independent from one another, there remains a need to carefully evaluate for both learning weaknesses and ADHD when problems present with academic performance. Barkley states that 75% of children referred for ADHD are found to have other co-morbid conditions including learning disabilities, Oppositional Defiant Disorder, anxiety disorder, depression, or conduct disorder. While these alternative conditions must be considered, student evaluation should always include some estimate of intellectual ability and measured academic achievement. It is important to recognize the distinct relationship between a students ability to learn and the ability to sustain attention.

Learning weaknesses and/or lower cognitive ability will predictably interfere with student attention. Although learning and intellectual weaknesses usually result with the symptom of inattention, they are qualitatively different from the disruption of ADHD. Theoretically, a learning disability is defined as an inability to interpret information correctly and link it with other learned information stored in different parts of the brain. Standardized tests often concentrate on evaluating a students ability to learn information primarily through the auditory and visual modes. A learning weakness can disrupt a students efforts to comprehend, organize, sequence, categorize, and associate concepts or ideas. A student impaired by learning disabilities can demonstrate inattention when they struggle to process challenging information or tasks.

A student can also show inattention when they attempt to learn information or complete tasks that exceed their ability level. In this case, intellectual ability governs how well the student can think, problem solve, understand abstractions, make abstract comparisons, use vocabulary to describe thoughts, and express ideas in verbal and written language. Weaknesses in any of these thinking and problem solving abilities can interfere with performance. Even Low Average range intellectual abilities can effectively interfere with a students routine efforts to comprehend and perform in the classroom. Ultimately, this student may feel lost, confused, or overwhelmed by the typical classroom curriculum. This inattentive and off-task behavior is often misinterpreted as ADHD rather than the actual thinking disruption recognized as part of lower cognitive ability. A student with lower intellectual abilities will demonstrate correspondent levels of poor attention. This means that attention is demonstrated at a level that conforms to the students cognitive ability.

These areas of performance weakness are routinely monitored by classroom teachers. While delays in academic skill development can be informally observed in the students daily performance, standardized assessment must be completed in order to formally identify either a learning disability or intellectual weakness. Testing can be completed by the special education team using achievement measures as well as an I.Q. test to evaluate the level of student functioning. Achievement measures will reflect what the student has learned through routine instruction. Intellectual testing will produce a theoretical ability score commonly recognized as innate thinking ability. It is then possible to compare the students achieved learning to the students theoretical ability to learn (I.Q.). Statistically significant differences between these two levels of performance will suggest the possibility of learning and thinking disabilities.

A referral for testing may be made by the classroom teacher in coordination with the students parents. Generally, federal guidelines allow a 45 day window for testing to be completed by a schools special education team. All testing results will be shared at a staffing coordinated with parents, teacher, and special education team in attendance. Due to the period of time necessary for this assessment process to occur, schools may often encourage parents to seek an ADHD evaluation prior to the special education staffing date. The intention of the ADHD evaluation will be to rule out the possibility of contributing deficits in the students ability to sustain attention to task.

Author Bio:

George Gallegos

George Gallegos is a licensed clinical psychologist practicing in the Sate of Colorado. He has maintained a private practice for over twenty five years during which time he has developed a long developing expertise with ADHD children. His current work with ADHD assessment and identification is conducted cooperatively with a large pediatric practice. Dr. Gallegos has more recently developed a 78-item test for ADHD entitled the ADHD Pre-Diagnostic Assessment (PDA). The PDA is an ADHD test for parents to use when initial concerns arise about their child. The PDA is intended as a primer measure when considering the possible need for a professional evaluation. The PDA can be used to discriminate essential factors that are predictive of ADHD or alternate conditions that interfere with classroom performance including learning.

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