Merck & Co., Inc. is a global research-driven pharmaceutical products company. Committed to bringing out the best in medicine
Contact usWorldwide
HomeAbout MerckProductsNewsroomInvestor InformationCareersResearchLicensingThe Merck Manuals

The Merck Manual--Second Home Edition logo
 
click here to go to the Index click here to go to the Table of Contents click here to go to the search page click here for purchasing information
Chapter 269. Behavioral and Developmental Problems in Young Children
Topics: Introduction | Eating Problems | Bed-Wetting | Encopresis | Sleep Problems | Temper Tantrums | Breath-Holding Spells | School Avoidance | Attention Deficit/Hyperactivity Disorder | Learning Disorders | Dyslexia
 
green line

Learning Disorders

Learning disorders involve an inability to acquire, retain, or broadly use specific skills or information, resulting from deficiencies in attention, memory, or reasoning and affecting academic performance.

Learning disorders are quite different from mental retardation and occur in children with normal or even high intellectual function. Learning disorders affect only certain functions, whereas in a child with mental retardation, difficulties affect cognitive functions broadly. There are three main types of learning disorders: reading disorders, disorders of written expression, and mathematics disorders. Thus, a child with a learning disorder may have significant difficulty understanding and learning math, but have no difficulty reading, writing, and performing well in other subjects. Dyslexia is the best known of the learning disorders. Learning disorders do not include learning problems that are due primarily to problems of vision, hearing, coordination, or emotional disturbance.

Although the causes of learning disorders are not fully understood, they include abnormalities in the basic processes involved in understanding or in using spoken or written language or numerical and spatial reasoning.

An estimated 3 to 15% of school children in the United States may need special educational services to compensate for learning disorders. Boys with learning disorders may outnumber girls five to one, although girls are often not recognized or diagnosed as having learning disorders.

Many children with behavioral problems perform poorly in school and are tested by educational psychologists for learning disorders. However, some children with certain types of learning disorders hide their deficits well, avoiding diagnosis, and therefore treatment, for a long time.

Symptoms

A young child may be slow to learn the names of colors or letters, to assign words to familiar objects, to count, and to progress in other early learning skills. Learning to read and write may be delayed. Other symptoms may be a short attention span and distractibility, halting speech, and a short memory span. The child may have difficulty with activities that require fine motor coordination, such as printing and copying.

A child with a learning disorder may have difficulty communicating. Some children initially become frustrated and later develop behavioral problems, such as being easily distracted, hyperactive, withdrawn, shy, or aggressive.

Diagnosis and Treatment

Children who are not reading or learning at the grade level expected for their verbal or intellectual abilities should be evaluated. Testing of hearing and eyesight should be carried out, because problems with these senses can also interfere with reading and writing skills.

A doctor examines the child for any physical disorders. The child takes a series of intelligence tests, both verbal and nonverbal, and academic tests of reading, writing, and arithmetic skills.

The most useful treatment for a learning disorder is education that is carefully tailored to the individual child. Measures such as eliminating food additives, taking large doses of vitamins, and analyzing the child's system for trace minerals are often tried but unproven. No drug treatment has much effect on academic achievement, intelligence, and general learning ability. Because some children with a learning disorder also have ADHD, certain drugs, such as methylphenidate, may improve attention and concentration, enhancing the child's ability to learn.

Site MapPrivacy PolicyTerms of UseCopyright 1995-2004 Merck & Co., Inc.