Reflections on Learning and Motor Skills Disorders


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Learning and Motor Skills Disorders as a category generally lump together learning disabilities (LD) including those associated with reading, written expression, mathematics, and motor control (developmental coordination disorder).  It’s important to note that the category of LD is rooted in the education field, not the medical, and that “individuals identified as having a learning disability constitute a highly heterogeneous group.”  (Netherton, Holmes, & Walker, 1999, p. 25)  Additionally, because so many disciplines serve the LD population, there is no standard definition for LD.  Although it might appear to be a matter of semantics, the definition does seem to matter… especially when it comes to who qualifies for a$$i$tance.

Regardless of what definition you choose, or what discipline you yield from, discrepancy is a key concept.  Learning Disorders (formerly Academic Skills Disorders) are diagnosed when the individual’s achievement on individually administered, standardized tests in reading, mathematics, or written expressions is substantially below that expected for age, schooling, and level of intelligence.  (American Psychiatric Association, Diagnostic and statistical manual of mental disorders, 2000, p. 49)  While there are a whole host of dimensional aspects we could use to measure discrepancy, it suffices to say that if there is a clinically significant delta between “the norm” and your client, the first pre-requisite is met.

Also implicit in the diagnosis of LD disorders is the concept of exclusion.  Learning Disorders must be differentiated from normal variations in academic attainment and from scholastic difficulties due to lack of opportunity, poor teaching, or cultural factors.  (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000, p. 51)  In addition, we should pay specific attention to special provisions we may need to provide for individuals with impaired vision or hearing, mental retardation.

Motor Skills Disorder presents us with a different set of challenges, including marked impairment in the development of motor concentration and/or significant interference with academic achievement or daily living.  Exclusions include various medical conditions, or mental retardation (unless the impairment exceeds what is usually associated with mental retardation).  (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000, p. 57)

On the whole, what surprised me most was that all learning disabilities are more prevalent in males than they are in females.  It was suggested in both the DSM –IV-R and the text that the increased attention to males may be due to sampling errors, or simply that males are more subject to behavior disorders.  I tend to think it’s the latter, it seems reasonable.

I also noticed that the statement that “the relative lack of specificity of the DSM-IV categories may serve to decrease their clinical usefulness.”  (Netherton et al., 1999, p. 28)  It’s evident to me that we intend to serve this population well we are going to have to team with the disciplines that “own” LD, namely education.  Reading and writing about learning disorders, I got the feeling that we, as psychologists, weren’t “on our home field” when discussing it.  Perhaps some of the other disciplines (educators) probably have more influence over it?

I think the concept of “learned helplessness” is also important to consider when diagnosing LD’s.  Perhaps we can contribute to growth though exercises that enrich and fortify self-image, self esteem, and motivational training.

Anyone reading this, or am I talking to myself? 😉

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

Netherton, S. D., Holmes, D., & Walker, C. E. (1999). Child and adolescent psychological disorders: A comprehensive textbook. Oxford, NY: Oxford University Press.

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3 thoughts on “Reflections on Learning and Motor Skills Disorders

  1. Kelly Sizemore

    I have ALWAYS All of my childhood into my adult hood have had a HUGE Prob; with CONCENTRATION. I have to ReRead an sentance over and over and over again to get it; No it’s i dont think it’s related to my ocd? I have to say my prayers out loud, I even read softly just to be able to get what i just read! I have also have this like ‘knee jerk’ thing that happens when I’m directng if the traffic is clear or not for my driver to go; I had it when I learned how to drive back in my late 30’s; I THOUGHT n my HEAD that it was all clear to go; so I gased it trying to get across the street; and got hit; I never drove again. What the HELL is wrong with my Brain?
    signed very Depressed; Sad.

    Reply
    1. Kent Brooks Post author

      Thanks for visiting the site, and thanks very much for the comment. I always preface my replies with the “don’t take any of this as medical or psychological advice” statement – mostly because I don’t have nearly enough information to provide really good guidance on your issues.

      I have a few questions – does your issue with concentration extend beyond reading? Do you also have trouble tracking verbally, or, mathematical concepts? Knowing the full range of situations in which this concentration issue occurs will inevitably be one of the questions asked by the individual from whom you seek treatment (if you decide to pursue that).

      It sounds like you have been diagnosed with Obsessive Compulsive Disorder (OCD)? What makes you think or believe that the two are unrelated? Is there a feeling of dread or fear that is usually associated with the OCD that is not present in the repetitious behavior when reading?

      On the knee jerk thing – I’m not sure I comprehend what you are trying to say there. It sounds like you, at some point, got into a traumatic car accident and that caused you to refrain from driving?

      Again – are the cognitive distortions you are describing isolated to the crosswalk, or do they tend to bleed out into other situations?

      I hope and pray that you are currently seeking treatment. I highly recommend going to see someone – even if finances will not allow there are usually very competent clinicians that take cases on a sliding scale, or even work pro bono. OCD + Depression + Cognitive Distrotions + Issues with Concentration and Memory is a complex constellation of issues that should be handled by a professional. Aside from that recommendation, I am not sure I can add anything additional without more information.

      Reply
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