4 September 2023

Understanding Learning Difficulties

By Annelize Clark, Occupational Therapist and Remedial Teacher at Bellavista School

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) consider specific learning difficulties to be neurodevelopmental. This means that they are present from birth, but often only manifest during pre-school and formal schooling years, and typically persists into adulthood. It has to do with how the brain is wired and how the brain processes information. There are different severities of specific learning difficulties -some children (and adults) may require substantial support, whereas others may require minimal support throughout their school career. Specific learning difficulties run in families, and occurs in people of all backgrounds.

The DSM-5 considers three overarching academic categories when looking at specific learning difficulties. These include reading, writing and mathematics. A child with specific learning difficulties presents with difficulty in learning and using academic skills, and their skills are below what is expected of their chronological age. Specific learning difficulties can occur across a range of intellectual levels, and the first signs are often that the child does not perform at the level that they appear capable of. It is also important to rule out other difficulties such as visual and auditory deficits, neurological disorders, or a lack of school attendance/ teaching, as these may all present as learning difficulties in one way or another.

Dyslexia is a specific learning difficulty that affects accurate and/or fluent word reading, written output and spelling. Most young learners with Dyslexia have been found to have difficulties with phonological awareness. This is the ability to identify separate speech sounds in a word and manipulate them. They may also have a difficulty in processing how letters represent those sounds and to retrieve the sounds from memory at a level of automaticity. A learner with Dyslexia is often identified as having a stronger oral language than written language. This means that the learner will be able to express ideas and concepts verbally, but when having to write it down, they appear to be functioning at a lower level of literacy development.

When looking at the overarching academic skill of writing, we can see there may be an overlap between Dyslexia and another specific learning difficulty called Dysgraphia. Dysgraphia affects how easily children acquire written language, and how well they use written language to express their thoughts. It is often associated with poor handwriting, either because of a motor difficulty, or because of a lack of practice from struggling with language organisation in written form. The child will have difficulty with spelling accuracy, grammar and punctuation accuracy, and difficulty with clarity or organisation of written expression.

The third overarching academic skill is Mathematics. Impairments in number sense, memorisation of number facts, accurate or fluent calculation skills, or accurate Mathematics reasoning difficulties may be an indication of general Mathematics difficulty or Dyscalculia. As with Dyslexia and Dysgraphia, Dyscalculia manifests as unexpected in relation to age, level of education and experience, and occurs across all ages and abilities. People with Dyscalculia have particular difficulty with subitising or dotted numeration of small sets. This is the ability to report how many items are in a set without counting the individual dots. They have a general difficulty understanding quantity and number.

Comorbidities between Dyslexia and Dyscalculia are quite high, with a co-occurrence of about 40%. Some overlapping behaviours and symptoms include poor working memory, poor organisational skills and poor sequencing skills. Because research in the field of Dyscalculia is still in its infancy stage, it is very difficult to establish accurate statistics for Dyscalculia. It is also thought that Dyscalculia and Dyspraxia (DCD) has an even higher co-occurrence rate, which may be due to differences in similar brain activation areas for Mathematics and motor co-ordination that may be affected.

Specific learning difficulties often co-occur, and children may present with additional neurodevelopmental traits such as concentration difficulties, lack in in organisational skills and/or memory difficulties. Specific learning difficulties are complex and require a professional such as an Educational Psychologist or Developmental Paediatrician to form an accurate diagnosis. There is also support and guidance available through Occupational Therapy, Speech and Language Therapy as well as Remedial Therapy and classroom support. Some learners may struggle with self-esteem as they become aware of their difficulties and start comparing themselves to their peers. It is therefore important for parents and children to seek guidance to support the whole family on both an academic level and an emotional level. For more information, visit www.bellavista.org.za

About Bellavista SHARE

Bellavista S.H.A.R.E. is the Education Resource Centre of Bellavista School, an independent school in Johannesburg that is widely regarded as a centre of excellence in the field of remedial education. With the Bellavista S.H.A.R.E initiative, the school harnesses the collective capacity it holds within its own staff to improve the quality of educational delivery in Southern Africa by sharing its wealth of professional knowledge, experience, and collective expertise with the community of educators and health professionals working with children in the region. 

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