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b. Statistics
i. It is estimated that approximately 6.5 million students between the
ages of 3 and 21 were receiving services for specific learning
disorder between 2009 and 2010
ii. Difficulties with reading are the most common of the learning
disorders and occur in some form in 4% to 10% of the general
population
iii. Mathematics disorder appears approximately 1% of the population,
but there is limited information about the prevalence of disorder of
written expression among children and adults
iv. More recent research indicates that boys and girls may be equally
affected by reading disorder
v. Students with specific learning disorders are more likely to drop out
of school, more likely to be unemployed, and more likely to have
suicidal thoughts and attempt suicide
vi. A group of disorders loosely identified as communication disorders
seem closely related to specific learning disorder
1. Childhood-onset Fluency Disorder
a. A disturbance in speech fluency that includes a
number of problems with speech, such as repeating
syllables or words, prolonging certain sounds, making
obvious pauses, or substituting words to replace one
that are more difficult to articulate
2. Language Disorder
a. Limited speech in all situations. Expressive language
(what is said) is significantly below receptive language
(what is understood)
3. Social (Pragmatic) Communication Disorder
a. Difficulties with the social aspects of verbal and
nonverbal communication, including verbosity,
prosody, excessive switching of topics, and dominating
conversations
c. Causes
i. It is clear that learning disorders run in families, and sophisticated
family and twin studies bear this out
ii. Genes are not specific, meaning that there are not different genes
responsible for reading disorders and mathematical disorders
1. They are genes that affect learning and they may contribute
to problem across domains
iii. Genes located on chromosomes 1, 2, 3, 6, 11, 12, 15, and 18 have
all been repeatedly linked to problems with word recognition
iv. Environmental influences such as the home reading habits of
families can significantly affect outcomes suggesting that reading
to children at risk for reading disorders can lessen the impact of
genetic influences
v. Three areas of the left hemisphere appear to be involved In
problems with dyslexia Brocas area (which affects articulation
and word analysis), an area in the left parietotemporal area (which
and there is evidence that those with ASD can improve their
socialization skills
ii. Biological Treatments
1. Medical intervention has had little positive impact on the core
symptoms of social and language difficulties
2. Major tranquilizers and serotonin-specific reuptake inhibitors
seem to be helpful
iii. Integrating Treatments
1. For children, most therapy consists of school education with
special psychological supports for problems with
communication and socialization. Behavioral approaches
have been most clearly documented as benefiting children in
this area
2. As children with ASD grow older, intervention focuses on
efforts to integrate them into the community, often with
supported living arrangements and work settings
E. Intellectual Disorder (Intellectual Developmental Disorder)
a. Overview
i. ID is a disorder evident in childhood as significantly below-average
intellectual and adaptive functioning
ii. DSM-5 identifies difficulties in three domains: conceptual, social,
and practical areas
b. Clinical Description
i. ID was previously included on Axis II of DSM IV TR.
1. The rationale for placing these disorders (including PD) on a
separate axis was that they tend to be more chronic and less
amenable to treatment, and second, it was to remind
clinicians to consider whether these disorders, if present,
were affecting Axis I disorder
ii. The DSM 5 criteria no longer include numeric cutoff for IQ scores
iii. To be diagnosed with ID, a person must have significantly
subaverage intellectual functioning, a determination made with one
of several IQ tests with cutoff score set by DSM 5 of approximately
70
iv. The second criterion calls for concurrent deficits or impairments in
adaptive functioning. A person must have also significant difficulty
in areas such as communication, self-care, home living, social and
interpersonal skills etc.
v. The final criterion for ID is the age of onset. The characteristic
below-average intellectual and adaptive abilities must be evident
before the person is 18
vi. Traditionally, classification systems have identified four levels of ID:
1. Mild: 50 55 and 70 IQ score
2. Moderate: 35 40 to 50 55 IQ score
3. Severe: ranging from 20 25 to 35 40 IQ score
4. Profound: below 20 25