Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Chapter 11
Communication and Learning Disorders
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Definitions
 Learning Disability: a general non-diagnostic term
for communication and learning problems that cannot
be attributed to other obvious conditions
 Communication Disorder: a diagnostic terms that
refers to problems producing speech sounds or with
speech fluency, using spoken language to
communicate, or understanding what other people
say
 Learning Disorder: a diagnostic terms that refers to
specific problems in reading, math, or writing ability,
as determined by achievement test results that are
lower than would be expected for one’s age,
schooling, and intelligence
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Language Development
 Infants selectively attend to parental speech sounds
 By age 1, they can recognize several words as well
as say a few words to express needs and emotions
 Perceptual maps are formed in the brain when
children hear phonemes repetitively; by age 1 the
map is complete and infants have lost the ability to
discriminate sounds not important to their own
language
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Language Development (cont.)
 Phonological awareness develops by age 7, and its
absence is a precursor to problems in reading and
expressive language development
 Language development is an indicator of general
mental ability- early language problems are highly
predictive of subsequent communication and learning
disorders
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Communication Disorders
 In the DSM-IV, communication disorders include:
 Expressive Language Disorder
 Phonological Disorder
 Mixed Receptive-Expressive Disorder
 Stuttering
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Expressive Language Disorder
 Characterized by deficits in expression despite
normal comprehension of speech
 To fit diagnostic criteria, problems must be severe
enough that they interfere with academic
achievement or the ability to communicate in
everyday social situations
 Children with ELD often have delayed and slowed
speech development, limited vocabulary, and speech
marked by short sentences and simple grammatical
structure
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Expressive Language Disorder (cont.)
 Differential Diagnosis
 if problems are coupled with difficulty
understanding some aspects of speech, child may
meet the criteria for a mixed receptive-expressive
language disorder
 when the problem is one of articulation or sound
production, rather than word knowledge, child may
meet the criteria for a phonological disorder
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Expressive Language Disorder (cont.)
 Prevalence and Course
 2% to 3% of children
 most children acquire normal language by mid- to
late adolescence
 early communication disorders linked to the later
onset of learning disorders
 associated with higher than normal rates of
negative behaviors
 only slightly more common in boys, although this
may reflect a referral bias due to their higher rates
of behavior problems
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Expressive Language Disorder (cont.)
 Causes
 family and twin studies suggest language
processes are heritable
 deficits in phonological awareness related to
problems in brain functioning within the posterior
left hemisphere
 recurrent middle ear infections in first year of life
may cause ELD in some children
 parental speech and language stimulation may
affect the pace and range of language
development, but not the specific impairments that
characterize disorders
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Expressive Language Disorder (cont.)
 Treatment of children with communication disorders
is often unnecessary, since many of these problems
are self-correcting soon after school entry
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Stuttering
 Repeated and prolonged pronunciation of certain
syllables that interferes with communication
 Gradual onset between ages 2 and 7, peak at age 5
 Affects males about 3 times more often than females
 Heritability accounts for 71% of variance in causes
 Most likely associated with abnormal development of
the left hemisphere
 Treatment, if necessary (80% no longer stutter after
about the first year of school), may include speaking
slower to child, removing pressure, and regulated
breathing method
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Learning Disorders
 In order to meet DSM criteria, performance in
reading, mathematics, and/or written expression must
be below what would be expected for someone of the
same age, schooling, and intelligence, and must also
significantly interfere with academic achievement or
daily living
 The different learning disorders overlap and build on
the same brain functions, hence people can have
more than one form of learning disorder
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Learning Disorders (cont.)
 Reading Disorder
 most common underlying feature is inability to
distinguish or separate sounds in spoken words
 often a difficulty learning basic sight words, such
as: the, what, laugh, said
 often errors in reversals (b/d, p/q), transpositions
(was/saw, scared/sacred), inversions (m/w, u/n),
and omissions (place for palace, section for
selection)
 core deficits in reading disorders are in decodingbreaking a word into parts rapidly enough to read
the whole word- coupled with problems reading
single, small words
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Learning Disorders (cont.)
 Mathematics Disorder
 difficulty in recognizing numbers and symbols,
memorizing facts, aligning numbers, and
understanding abstract concepts
 may have problems in visual-spatial ability
 core deficits in arithmetic calculation and/or
mathematics reasoning abilities
 underlying neuropsychological processes are
believed to be underdeveloped or impaired
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Figure 11.2 An example of a calculation error that shows errors suggesting spatial
difficulties and directional confusion.
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Learning Disorders (cont.)
 Writing Disorder:
 children with writing disorders typically produce
shorter, less interesting, and poorly organized
essays, and are less likely to review spelling,
punctuation, and grammar
 often associated with problems with eye/hand
coordination (which leads to poor handwriting),
despite normal gross motor development
 commonly found in combination with a learning
disorder in reading or mathematics
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Figure 11.3 Top: Drawings produced by Carlos when asked to copy a triangle, a
circle, and a square. Bottom: Examples of a triangle, circle and square from a
normally developing 7-year-old boy.
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Figure 11.3 Top: Drawings produced by Carlos when asked to copy a triangle, a
circle, and a square. Bottom: Examples of a triangle, circle and square from a
normally developing 7-year-old boy.
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Prevalence of Learning Disorders
 Estimates range from 2% to 10% of the population
 Reading disorders most common (and overlap
considerably with math and writing disorders),
followed by mathematics disorders, and then writing
disorders (rare when not associated with another LD)
 More common in males (most likely reflecting a
referral bias due to comorbid behavior problems)
 Social and cultural factors may affect how children
with LDs are identified and diagnosed
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Course of Learning Disorders
 Many children with LDs are at risk for social and
psychological problems, including poor academic
self-concept, depression, behavior problems, social
skills deficits, and dropping out of school
 LDs often life-long, although in adulthood individuals
may excel in areas not related to their difficulties
 In the long-run, women with LDs have more
adjustment problems, especially with respect to
relationships
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Figure 11.4 Percentage of clinically significant behavior problems among children with
and without learning disorders, at 4 years and 8 years of age. Data from Benasich et
al., 1993.
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Causes of Learning Disorders
 Most likely cause is genetic-based neurological
problem
 Most LDs stem from difficulties bringing together
information from different brain regions into
“convergence zones” where it is integrated and
understood
 Reading and language-based problems appear to be
associated with cellular abnormalities in brain’s left
hemisphere, especially in the planum temporale
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Causes of Learning Disorders (cont.)
 Children with learning problems have been found to
have an immature form of EEG activation, and lower
activation in primarily the left hemisphere of the brain
has been found in children with dyslexia
 Language-based LDs may be associated with
“timing” deficits at the level of the nervous system,
resulting in problems in visual and auditory
discrimination
 Non-verbal learning disabilities may result from
deficits in right hemisphere brain functioning, and
have been linked to prenatal and early childhood
disease and trauma
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Figure 11.6 A biobehavioral systems model.
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Treatment and Prevention of LDs
 Early identification and treatment leads to better
outcomes
 The Regular Education Initiatives places students
with LDs in general classrooms with both general and
special teachers
 Direct instruction is often best for children with LDs- a
straightforward approach to teaching based on the
premise that to improve a skill, the instructional
activities have to approximate those of the skill being
taught
Abnormal Child Psychology, 3rd Edition, Eric J. Mash, David A. Wolfe
Chapter 11: Communication and Learning Disorders
Treatment and Prevention (cont.)
 Behavioral strategies focus on slowing down the presentation
of material, breaking learning into manageable steps, making
learning highly structured, and employing reinforcement and
practice opportunities
 Cognitive-behavioral approaches teach children to monitor
their own thought processes and emphasize the use of
strategies such as self-monitoring, self-assessment, selfrecording, and self-management of reinforcement
 Computer-assisted learning techniques can help children to
distinguish sounds and improve language understanding