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Learning Disabilities from the National Institute of Mental Health

Learning Disabilities




But the prospects are hopeful. It is important to remember that a person with a learning disability can learn. The disability usually only affects certain limited areas of a child's development. In fact, rarely are learning disabilities severe enough to impair a person's potential to live a happy, normal life.

This booklet is provided by the National Institute of Mental Health (NIMH), the Federal agency that supports research nationwide on the brain, mental illnesses, and mental health. Scientists supported by NIMH are dedicated to understanding the workings and interrelationships of the various regions of the brain, and to finding preventions and treatments to overcome brain dysfunctions that handicap people in school, work, and play.

The booklet provides up--to-date information on learning disabilities and the role of NIMH-sponsored research in discovering underlying causes and effective treatments. It describes treatment options, strategies for coping, and sources of information and support. Among these sources are doctors, special education teachers, and mental health professionals who can help identify learning disabilities and recommend the right combination of medical, psychosocial, and educational treatment.

In this booklet, you'll also read the stories of Susan, Wallace, and Dennis, three people who have learning disabilities. Although each had a rough start, with help they learned to cope with their handicaps. You'll see their early frustrations, their steps toward getting help, and their hopes for the future.


Table Of Contents:

Understanding the Problem

Getting Help

Sustaining Hope

  • Can learning disabilities be outgrown or cured?
  • What aid does the Government offer?
  • What hope does research offer?
  • What are sources of information and support?



    At age 14, Susan still tends to be quiet. Ever since she was a child, she was so withdrawn that people sometimes forgot she was there. She seemed to drift into a world of her own. When she did talk, she often called objects by the wrong names. She had few friends and mostly played with dolls or her little sister. In school, Susan hated reading and math because none of the letters, numbers or "+" and "-" signs made any sense. She felt awful about herself. She'd been told--and was convinced--that she was retarded.


    Wallace has lived 46 years, and still has trouble understanding what people say. Even as a boy, many words sounded alike. His father patiently said things over and over. But whenever his mother was drunk, she flew into a rage and spanked him for not listening. Wallace's speech also came out funny. He had such problems saying words that in school his teacher sometimes couldn't understand him. When classmates called him a "dummy," his fists just seemed to take over.


    Dennis is 23 years old and still seems to have too much energy. But he had always been an overactive boy, sometimes jumping on the sofa for hours until he collapsed with exhaustion. In grade school, he never sat still. He interrupted lessons. But he was a friendly, well-meaning kid, so adults didn't get too angry. His academic problems became evident in third grade, when his teacher realized that Dennis could only recognize a few words and wrote like a first grader. She recommended that Dennis repeat third grade, to give him time to "catch up." After another full year, his behavior was still out of control, and his reading and writing had not improved.

    What Is a Learning Disability?

    Unlike other disabilities, such as paralysis or blindness, a learning disability (LD) is a hidden handicap. A learning disability doesn't disfigure or leave visible signs that would invite others to be understanding or offer support. A woman once blurted to Wallace, "You seem so intelligent--you don't look handicapped!"



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    What Are the Types of Learning Disabilities?

    "Learning disability" is not a diagnosis in the same sense as "chickenpox" or "mumps." Chickenpox and mumps imply a single, known cause with a predictable set of symptoms. Rather, LD is a broad term that covers a pool of possible causes, symptoms, treatments, and outcomes. Partly because learning disabilities can show up in so many forms, it is difficult to diagnose or to pinpoint the causes. And no one knows of a pill or remedy that will cure them.

    Not all learning problems are necessarily learning disabilities. Many children are simply slower in developing certain skills. Because children show natural differences in their rate of development, sometimes what seems to be a learning disability may simply be a delay in maturation. To be diagnosed as a learning disability, specific criteria must be met.

    The criteria and characteristics for diagnosing learning disabilities appear in a reference book called the DSM (short for the Diagnostic and Statistical Manual of Mental Disorders). The DSM diagnosis is commonly used when applying for health insurance coverage of diagnostic and treatment services.

    Learning disabilities can be divided into three broad categories:
    • Developmental speech and language disorders
    • Academic skills disorders

    Each of these categories includes a number of more specific disorders.

    Developmental Speech and Language Disorders

    Speech and language problems are often the earliest indicators of a learning disability. People with developmental speech and language disorders have difficulty producing speech sounds, using spoken language to communicate, or understanding what other people say. Depending on the problem, the specific diagnosis may be:

    • Developmental articulation disorder
    • Developmental expressive language disorder
    • Developmental receptive language disorder




    Of course, in preschoolers, some misuse of sounds, words, or grammar is a normal part of learning to speak. It's only when these problems persist that there is any cause for concern.

    Academic Skills Disorders

    Students with academic skills disorders are often years behind their classmates in developing reading, writing, or arithmetic skills. The diagnoses in this category include:

    • Developmental reading disorder
    • Developmental writing disorder
    • Developmental arithmetic disorder



    • Focus attention on the printed marks and control eye movements across the page
    • Recognize the sounds associated with letters
    • Understand words and grammar
    • Build ideas and images
    • Compare new ideas to what you already know
    • Store ideas in memory

    Such mental juggling requires a rich, intact network of nerve cells that connect the brain's centers of vision, language, and memory.







    "Other" Learning Disabilities


    Attention Disorders






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    What Causes Learning Disabilities

    Understandably, one of the first questions parents ask when they learn their child has a learning disorder is "Why? What went wrong?"




    Today, a leading theory is that learning disabilities stem from subtle disturbances in brain structures and functions. Some scientists believe that, in many cases, the disturbance begins before birth.

    Errors in Fetal Brain Development

    Throughout pregnancy, the fetal brain develops from a few all-purpose cells into a complex organ made of billions of specialized, interconnected nerve cells called neurons. During this amazing evolution, things can go wrong that may alter how the neurons form or interconnect.

    In the early stages of pregnancy, the brain stem forms. It controls basic life functions such as breathing and digestion. Later, a deep ridge divides the cerebrum--the thinking part of the brain--into two halves, a right and left hemisphere. Finally, the areas involved with processing sight, sound, and other senses develop, as well as the areas associated with attention, thinking, and emotion.

    As new cells form, they move into place to create various brain structures. Nerve cells rapidly grow to form networks with other parts of the brain. These networks are what allow information to be shared among various regions of the brain.

    Throughout pregnancy, this brain development is vulnerable to disruptions. If the disruption occurs early, the fetus may die, or the infant may be born with widespread disabilities and possibly mental retardation. If the disruption occurs later, when the cells are becoming specialized and moving into place, it may leave errors in the cell makeup, location, or connections. Some scientists believe that these errors may later show up as learning disorders.

    Other Factors That Affect Brain Development

    Through experiments with animals, scientists at NIMH and other research facilities are tracking clues to determine what disrupts brain development. By studying the normal processes of brain development, scientists can better understand what can go wrong. Some of these studies are examining how genes, substance abuse, pregnancy problems, and toxins may affect the developing brain.



    Tobacco, Alcohol, and Other Drug Use -- Many drugs taken by the mother pass directly to the fetus. Research shows that a mother's use of cigarettes, alcohol, or other drugs during pregnancy may have damaging effects on the unborn child. Therefore, to prevent potential harm to developing babies, the U.S. Public Health Service supports efforts to make people aware of the possible dangers of smoking, drinking, and using drugs.


    Alcohol also may be dangerous to the fetus' developing brain. It appears that alcohol may distort the developing neurons. Heavy alcohol use during pregnancy has been linked to fetal alcohol syndrome, a condition that can lead to low birth weigh, intellectual impairment, hyperactivity, and certain physical defects. Any alcohol use during pregnancy, however, may influence the child's development and lead to problems with learning, attention, memory, or problem solving. Because scientists have not yet identified "safe" levels, alcohol should be used cautiously by women who are pregnant or who may soon become pregnant.


    Problems During Pregnancy or Delivery -- Other possible causes of learning disabilities involve complications during pregnancy. In some cases, the mother's immune system reacts to the ferns and attacks it as if it were an infection. This type of disruption seems to cause newly formed brain cells to settle in the wrong part of the brain. Or during delivery, the umbilical cord may become twisted and temporarily cut off oxygen to the fetus. This, too, can impair brain functions and lead to LD.

    Toxins in the Child's Environment -- New brain cells and neural networks continue to be produced for a year or so after the child is born. These cells are vulnerable to certain disruptions, also.

    Researchers are looking into environmental toxins that may lead to learning disabilities, possibly by disrupting childhood brain development or brain processes. Cadmium and lead, both prevalent in the environment, are becoming a leading focus of neurological research. Cadmium, used in making some steel products, can get into the soil, then into the foods we eat. Lead was once common in paint and gasoline, and is still present in some water pipes. A study of animals sponsored by the National Institutes of Health showed a connection between exposure to lead and learning difficulties. In the study, rats exposed to lead experienced changes in their brainwaves, slowing their ability to learn. The learning problems lasted for weeks, long after the rats were no longer exposed to lead.

    In addition, there is growing evidence that learning problems may develop in children with cancer who had been treated with chemotherapy or radiation at an early age. This seems particularly true of children with brain tumors who received radiation to the skull.

    Are Learning Disabilities Related to Differences in the Brain?

    In comparing people with and without learning disabilities, scientists have observed certain differences in the structure and functioning of the brain. For example, new research indicates that there may be variations in the brain structure called the planum temporale, a language-related area found in both sides of the brain. In people with dyslexia, the two structures were found to be equal in size. In people who are not dyslexic, however, the left planum temporale was noticeably larger. Some scientists believe reading problems may be related to such differences.

    With more research, scientists hope to learn precisely how differences in the structures and processes of the brain contribute to learning disabilities, and how these differences might be treated or prevented.

    Back to Contents

    Next: Getting Help.



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