JOURNAL OF THE NATIONAL ACADEMY FOR CHILD DEVELOPMENT
1986, Volume 6, No. 8
The Learning "Disabled" Child:
Special Education
Robert J. Doman Jr.
Special Education
Twenty-five years ago, special education
was in its infancy. It was virtually impossible for the parents
of children with severe problems to obtain any services from
their school systems. With the recent development of special
education and the passing of legislation providing for children
with special needs, funds are now available through state
and federal governments to supplement the education of these
children. An effort is being made to evaluate and place more
and more children, and as a result, the numbers of "special"
programs have increased, and many children are being inappropriately
labeled and placed in special classes.
Special Education Placement and Classification
Children are being labeled as learning
disabled, hyperactive, neurologically impaired, etc., and
are being assigned special class placement, while proper programs
are still not available for children with severe problems.
Each year, new classifications arise for those individuals
who do not "fit" into the regular, "normal"
classroom. In some areas, as many as 40 percent of the school
population is currently pigeon-holed to fit into one of these
categories. Fortunately for most of us, we were attending
school during a period when these classifications did not
exist. If they had, a large percentage of us would have been
placed in special classrooms, attached with special labels.
Stigmas of Labelization
It is important to note that the classifications
are administrative ones and they are not a diagnosis, for
there is no such disease as hyperkinesis, hyperactivity, learning
disabled, etc. These are merely symptoms of a problem, and
they are not the problem itself. Children who are placed in
these special-education categories become stigmatized by the
label because they are segregated and thrust into an abnormal
environment that makes it virtually impossible for them to
learn normal, appropriate behaviors. Obviously, a child is
incapable of learning normal behavior in an abnormal environment.
Accordingly, these children, instead of having a great opportunity
to succeed, have even less of a chance.
The Use of Drugs
Sadly, many of these labeled children
are also placed on drugs in an effort to quiet and calm them
down. Estimates of the number of "learning disabled"
or "hyperactive" children on drugs go as high as
3 million children in this country today. It is amazing that
the education-medical establishment can rationalize the placement
of such a large group of children on amphetamines and other
drugs during a period when we hear through various media of
a public outcry denouncing the usage of drugs in our society
by children.
Identification of Problems
The youth of today often exhibit difficulties
in various facets of education such as reading, mathematics,
etc. Not long ago, I lectured to a group of parents in a community
where the most popular labels attached to children were neurologically
impaired and communicationally handicapped. The parents pressed
me to identify the terms I would use to label such children.
My response was, "I call these children easy." When
one of these children would walk into my office, I usually
would think, "Here comes one that is easy" or "there's
an easy one." Why? Because the problems of these children
are easy to identify and generally easy to remediate, as the
children are often found to be what is termed neurologically
dysorganized.
Neurological Dysorganization
A child who is found to be lacking
in complete neurological organization is, to some degree,
neurologically dysorganized. To a large extent, this is an
environmental problem or an inherited problem, as opposed
to organic dysorganization such as would be found in a child
who is suffering from a brain injury. The first step in detecting
neurological dysorganization is to evaluate the child against
the developmental profile and to have him tested to rule out
the possibility of an organic problem.
Evaluation of Dysorganization
NACD's evaluation of these children
begins by determining the organization at the brain level
of the pons. This is ascertained while viewing the child's
ability to crawl on his stomach. The child should be able
to crawl on his stomach in what is termed a "cross pattern"
without receiving specific instruction. Cross-pattern crawling
is forward movement where the child extends his right arm
and pulls up his left leg, pushing and pulling with the right
arm and left leg. He then alternates his movement so that
he is pushing and pulling with the left arm and right leg.
If the child crawls in what is called a homolateral pattern
(which is pushing and pulling with the right arm and right
leg, and then the left arm and left leg) he is exhibiting
a degree of dysorganization at that level. If the child crawls
without a pattern or in a manner where he is extending both
arms forward and pulling both legs up, he is also reflecting
dysorganization in the pons area of the brain.
Mid-brain Evaluation
Advancing to the mid-brain, organization
or dysorganization can be assessed by examining the child's
ability to creep on his hands and knees. Remember, you crawl
before you creep. Crawling is on the stomach, and creeping
is on the hands and knees. The child should also creep in
a cross pattern. Properly, the child's hands should be extended
flat on the floor with fingers pointing forward. Ideally,
the child should be looking forward at the extended hand.
Again, if the child creeps in a homologous (bunny hop) or
a homolateral pattern (right arm and right leg) he is exhibiting
a degree of dysorganization. In assessing your child's ability
to creep, it is necessary that you have him creep at various
speeds, with varied amounts of starting and stopping. A child
properly organized at this level should never go into the
homolateral pattern or homologous pattern.
The Cortex
Progressing up into the lower cortex
area of the brain, you may evaluate organization by viewing
the child's ability to walk. Instruct the child to walk across
the room while he points at his feet, and assess whether he
is walking in a homolateral pattern or a cross pattern. You
may wish to demonstrate to the child what you intend him to
do, then have him mimic your actions. Have the child follow
your instructions while starting and stopping his movement
several times. Any hesitation he displays about which hand
to point is an indication of dysorganization. He should be
pointing opposite hand to opposite foot, and should not walk
in a homolateral pattern. There are many children who lack
this cross-pattern function, and they reflect coordination
problems to a certain extent. Coordinated gross motor action
culminates in a cross pattern whether it's bowling, doing
a basketball lay-up, or throwing a baseball pitch. A child
who lacks complete organization will display a loss of coordination
to some degree. Interestingly, there is the rare child who
is neurologically dysorganized but has good coordination.
Such children generally have other inefficiencies, particularly
mixed dominance.
Cortical Hemispheric Dominance
Neurological organization culminates
at the top cortical level of the brain. This organization
is the establishment of cortical-hemispheric dominance. This
is the establishment of a dominant hemisphere, or side. A
completely organized child should be right-handed, right-footed,
right-eared, and right-eyed, or left-handed, left-footed,
and so on.
Assessment of Dominance
To assess your child's dominance, begin
by evaluating the function of his hands. You can find out
if he has a dominant hand, as this will be the hand he writes
with, throws a ball with, etc. These functions should all
be done with the same hand. If a child writes with one hand
and throws a ball with the opposite hand, he obviously is
displaying mixed dominance. Assessment of foot dominance is
essentially done by using the same method, observing which
foot the child kicks with, hops with, etc.
To assess auditory dominance, have
the child put his ear next to the door and attempt to listen
to conversation that is emanating from the other side. Speak
very softly so that the child leans toward you. The child
will turn his head to either the right or left so that the
dominant ear is closest to the source of the sound.
Assessment of visual dominance is accomplished
at what is called near point and far point, using vision as
close as three feet and at a further distance. To assess the
child at a distance, have him point his finger toward your
finger while you extend your arm and point your finger toward
the child. If you sight along your finger to his finger, you
can find out which eye he is using. You may wish to have him
alternate his extended arm from right to left to double check
your findings. Also have the child look into a telescope or
kaleidoscope, as he will invariably use the dominant eye.
At near point place a one-eighth inch
dot on a piece of paper and put another paper with a one-eighth
inch hole in the center on top. Line up the hole with the
dot so that the child can see the dot by looking through the
hole on the top piece of paper. Have the child grasp the paper
with the hole in both hands and slowly move the paper up to
his eye, watching the dot the entire time. Again, watch which
eye the child brings the paper to, as it will invariably be
the dominant eye.
A completely organized child will have
a dominant hand, foot, ear, and eye, which will be all on
the same side. If the child lacks complete dominance in any
area or does not exhibit dominance on the same side, it's
a reflection of a degree of neurological dysorganization.
How Dysorganization Affects Function
If the child lacks a controlling hemisphere
of the brain organization is lacking because the influx of
information to the brain is not occurring correctly. For instance,
a child may take visual information through his right eye
and store it in his left hemisphere. When a child neglects
to take in information from one side and place it in one hemisphere
he is not establishing firm pathways into the brain. The child
cannot efficiently process that information. You might view
the dysorganization as a room filled with filing cabinets.
If he is properly organized all of the files are in alphabetical
order and he can place a piece of information in and extract
it efficiently. A dysorganized child's files are not alphabetized,
and he may absorb the information but when he attempts to
retrieve it he may be unable to do so. These children are
classically the ones who study for a test one night, only
to fail when they go in to take it. They took in the information
but lost it when they attempted to retrieve it. When you place
these children under any type of stress, the system immediately
begins falling apart, and their function diminishes. Often
these children neglect to remember a homework assignment from
the previous night, yet they can remember what color dress
mother wore on Christmas two years previously. These individuals
are not lacking innate intelligence. They just cannot properly
take in information, assimilate it, process it, and bring
it back out again.
Categorization and Classification
Categories and classifications depend
to a large extent on the particular school system or district
that the child is placed in. In one school district the child
may be labeled as learning disabled, while in another he may
be categorized as hyperactive. This is the same child with
the same problem, but for the most part there are some differences
in the symptoms of the children that are placed in these various
categories.
The Hyperactive Child
A child who is severely hyperactive
is possibly a child with an organic problem, such as a slight
brain injury or metabolic problem. Many of these children
may be helped through dietary restrictions or medical intervention.
A large percentage of the children labeled as hyperactive
are those who the teacher feels move around too much, are
easily distracted, and/or exhibit a short attention span.
There are many bright children who display these same characteristics.
It is amazing that often a child who has been thus labeled
can sit in front of a television set for an hour straight
without losing interest.
Abnormal Learning Environments
Some children are placed in a learning
environment that is inappropriate for them. The pace is too
slow, the material covered is below their intellectual level,
etc. Such a child needs to be challenged and stimulated, and
he is not receiving this in his present learning environment.
Young children are much brighter and quicker than we often
assume, and we may assess a learning environment as appropriate
for them when in reality the pace is too slow. As an example,
I reflect back to when my son was in kindergarten. I received
a call from the school saying my son possibly had a problem
in that he seemed slightly hyperactive and had a short attention
span. This characterized itself during story time. I went
in to observe as the teacher arranged the class in a semi-circle
and began reading a story. Sure enough, during the reading
my son got up and went to the rear of the classroom where
the books were stored and picked one out and began reading.
After the teacher finished her reading, she came over to me
and said, "Look! See what I mean? He has a short attention
span and is unable to sit quietly while I read the story."
I told her that I would have been disappointed if he had remained
seated, because he had read that book over a year ago.He was
not hyperactive and he did not have a short attention span.
He was merely bored. The teacher was reading material that
he was already familiar with, and it was below his present
intellectual level. It follows that a large percentage of
the children diagnosed as hyperactive or hyperkinetic are
in reality children who are bright but are bored at their
school's slow pace.
Learning Disabled Child
The child with this label usually is
a child who is a classic example of neurological dysorganization.
However, some children who are diagnosed as learning disabled
have no problem at all, other than being situated in a learning
environment that incorporates an inappropriate program. For
instance, when you place a child who is a visual learner in
a classroom atmosphere with an auditory approach to reading
such as phonics, the child will often fail, not because he
is incapable of learning to read but because he is a visual
learner and has been placed in an auditory program. On numerous
occasions, parents have brought their children into our offices
claiming that they were failing first or second grade. Often
it was the type of learning environment that actually played
the key role in the problem. Often it was discovered that
the children not only could read, but actually were reading
above their grade level. These were children who for the most
part had been instructed in kindergarten or nursery school
to read by sight and were being tested on their grasp of phonics
rather than their individual ability to read.
A child who is heavily visual or auditory
does need some remediation in terms of developing the other
modality. Such a child can be situated in a home program to
strengthen his ability to assimilate and process visual or
auditory information, depending upon which function was found
lacking.
The Effects of Dysorganization
One of the effects of dysorganization
and lack of a dominant hemisphere is often a problem with
language-related activities, such as verbal language and reading.
Language is a function of the dominant hemisphere, and if
the child is dysorganized, he often has a handicap in terms
of his language function. Interestingly, children who lack
cortical-hemispheric dominance often have good musical abilities.
Music is a function of the sub-dominant hemisphere. To clarify
this, reflect on someone who has experienced a stroke. If
the stroke occurred in the dominant hemisphere of the brain,
the person quite possibly could have lost the ability to speak.
If the same individual who could not speak were asked to sing,
he quite possibly could do so, since music is not in the dominant
hemisphere that was affected by the stroke.
The average child does not generally
establish dominance until the end of first grade, although
a child's development can be accelerated to the point where
dominance may be realized at the age of 2 or 3 years. However,
placing children in a musical environment prior to establishment
of dominance acts to reinforce the sub-dominant hemisphere,
thus delaying the establishment of dominance. In many cases,
without specific remediation we are making that child neurologically
dysorganized in such a fashion that he may never become properly
organized. Once the child exceeds the age of 6, he has become
fixed in his method of accomplishing acts in a particular
mode, such as writing with the left hand, kicking with the
right food, etc. He will not naturally alter organization
to become properly dominant. Specific remediation must take
place if we are to correct the organization dysfunction.
The child who is labeled as having
a communication handicap is one who lacks dominance, since
language functions in the dominant hemisphere. This is the
same type of problem experienced by individuals who stutter.
We are able to listen to the stuttering child jump from hemisphere
to hemisphere in an attempt to communicate.
Behavioral Problems
Children identified as having a behavior
problem are generally easy to remediate, with appropriate
treatment and management. The problem, however, can be a severe
handicap for the child. The dysorganized but otherwise bright
child, who is presently not functioning at the same level
as his peers, questions his own intelligence and dwells upon
what is wrong and why he is different. A large portion of
these children eventually (at approximately the third grade
level) develop behavior problems. These behavioral problems
can originate as a self-defense mechanism, one that the child
formulates in an effort to protect his battered ego. If a
child tries and fails, he generally is left with only one
recourse, which is to internalize the belief that he is of
below normal intelligence. Therefore, it is safer in the terms
of his ego protection to not try at all or to act out. He
then can blame his failure on the fact that he did not try,
which is much easier for him to live with.
Children labeled as behavior problems
will develop a poor self-image, particularly if they are placed
in a special class. Every child attending school knows who
is placed in a special classroom, and the child becomes an
object of taunting and ridicule by his peers, which only serves
to strengthen his poor self- image. He is segregated at the
school and in the neighborhood, which correspondingly alters
the child's behavior to produce feelings of despondency that
force the child to withdraw and be come introverted and often
aggressive. These children seem to be always getting into
fights, and very often it is they who initiate the quarrel.
Sexual Disparity
The problems of hyperactivity, learning
disability, etc., are more commonly attributed to boys than
they are to girls. The primary cause of this disparity between
the sexes is a matter of motivation and getting a proper start
in life. Before children enter a classroom environment, little
girls are in the house playing school while their male counterparts
are outside rough-housing and playing in the dirt.
A friend called one day in hysterics,
stating that her son in kindergarten received a report from
his teacher stating that he had flunked paper-cutting. The
mother was at a loss to explain why her son had failed, and
she desired to know what this failure entailed. There was
absolutely nothing wrong with the child. He was very active
and bright. He just had not received prior experience in cutting,
which is a problem you would rarely find in a girl as they
are continually cutting out paper dolls and making dresses
for them, etc. Girls have the advantage of starting school
on the right foot, since they play school at an early age
and are interested in reading quietly in their mothers' laps
and listening to stories, thereby internalizing various words
and phrases spoken. As a result of this prior knowledge, they
generally succeed in the early stages of school. That is not
to say that females do not exist who fall into the various
categories of learning disabled and hyperkinetic. However,
the ratio within these categories is three boys to every one
girl.
Difficulties in the Classroom
One of the great tragedies of this
era is that many children are being classified and labeled,
restricted in their opportunities and being denied the opportunities
of reaching their potentials. A child who has been placed
in a special-education classroom rarely ever leaves the classroom.
Since the curriculum in the special classroom is geared below
that of the normal class, no matter how well the child progresses
each year, he inevitably falls behind his peers in their regular
classroom. In addition to this problem, he also has been labeled,
which provides not only a social stigma but destroys the child's
own self-image. If data were available, it is quite possible
that we would discover adolescent suicides are much higher
among those children who have been labeled and classified
compared to those who have not.
As the school systems develop these
programs, they are placing labels on the children at earlier
and earlier ages. Within the next few years we will see more
and more schools taking responsibility for children at ages
2 or 3. One of the initial steps the school will develop is
to test and evaluate the child. The children are no longer
attached with relatively harmless labels such a being lazy
or full of beans or he is all boy. Now the child is learning-disabled,
hyperactive, or behavioral disordered. There's a potential
for great danger in this, in that millions of children run
the risk of being permanently disabled through the process
of having these labels thrust upon them.
Goals of Home Programs
When we work on home programs with
children with mild dysorganization on the pons, mid-brain,
and cortical levels, we can often alleviate these minor problems
within a six-month period. If the child has a more severe
problem, therapeutical measures would take a longer amount
of time for complete remediation. We set home-program goals
for children with minor problems as high as advancing academically
in reading and math at a rate of one year's growth within
every three-month period.
Rapid advancement is not as difficult
as it may sound, because concurrently we are improving the
child's neurological functions, enabling him to absorb information
and process it at a much faster rate. We also design the academic
program to fit the needs of each individual child. Quite often
we only require thirty minutes a day for the child's instruction,
for both the neurological and academic portions of the program.
The future can be bright for these
children if the problem itself is treated and not the symptoms.
We must also avoid the labels, stigma, and destruction of
the child's self-image.
Reprinted from the Journal
of the National
Academy for Child Development
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