Baby Memorial Hospital, Kozhikode, Kerala, India. PIN: 673004
Abstract
Several factors contribute to scholastic backwardness in
children. Causes include specific developmental disorders of
scholastic skills, low intelligence, chronic illnesses,
family dysfunction, social problems, attention deficits, and
emotional disorders. Children with specific
developmental disorders of scholastic skills experience
significant impairment in the acquisition of reading,
writing and mathematical skills. If not remedied at the
earliest, these children are at risk of developing
severe stress related disorders. There is high comorbidity
of behaviour disorders and emotional disorders in these
children. Hence early intensive remedial education is
essential in the management of children with specific
developmental disorders of scholastic skills.
Key Words: Scholastic backwardness,
specific developmental disorders of scholastic skills
Introduction
There are several causes for scholastic backwardness, which
include specific developmental disorders of scholastic
skills (SDDSS), below average intelligence, attention
deficit hyperactivity disorder, chronic illnesses, emotional
disorders as well as problems in school and home environment
[1,2,3].
Children with poor scholastic performance become source of
immense stress for parents and teachers, which in turn,
reduce the self-confidence of children. These children are
at risk of developing stress related disorders and behaviour
disorders. The misery of children with scholastic
backwardness should be alleviated. Among the children with
poor scholastic performance, we should focus our attention
primarily on children with specific developmental disorders
of scholastic skills because, remediation works the best in
these children. They can be successfully managed and we can
guide them to become professionals in the areas of their
strengths. Children with SDDSS have disturbances in
acquisition of scholastic skills from early stages of
development. These disturbances are not due to lack of
opportunity to learn. They are not mentally retarded and
they do not have acquired brain disease or trauma [1]. These
children have significant impairment in areas related to
reading, writing and arithmetical skills. The subtypes of
SDDSS frequently co-occur with one another [4].
Subtypes of Specific Developmental Disorders
of Scholastic Skills
Specific Reading Disorder
Children with specific reading disorder have significant
impairment in the development of reading skills [5]. The
reading performance will be significantly below the level
expected on the basis of age, general intelligence and
school placement. They experience significant impairment in
the acquisition of reading accuracy, reading fluency and
reading comprehension which cannot be accounted for by low
IQ, visual acuity problems, neurological damage or poor
educational opportunities [6].
Specific Spelling Disorder
There is specific and significant impairment in the
development of spelling skills. The spelling skills of the
child will be significantly below the expected level related
to age, general intelligence and school placement. Ability
to spell orally and to write the words correctly, will be
impaired. This will also be associated with grammatical
errors, punctuation errors, poor paragraph organization and
poor handwriting.
Specific Disorder of Arithmetical skills
The arithmetical skills of the child will be significantly
below the expected level based on age, general intelligence
and school placement. The arithmetical difficulties include
failure to understand the basic concepts of maths, inability
to understand mathematical terms or signs and difficulty in
learning mathematical tables. Children with mathematics
difficulties have deficits associated with fact retrieval.
They also have defects in problem conceptualization and
calculation [7]. These children have problems with
identification of numbers, counting and retrieval of
arithmetic combinations [8]. Children with mathematical
difficulties also have deficits in place value concepts and
number sense [9]. The mathematical and cognitive
performances of students with mathematics learning
disabilities are significantly lower compared to age or
grade-matched students with no learning disabilities [10
].
Mixed Disorder of Scholastic Skills
In this category, arithmetical and reading or
spelling skills are significantly impaired.
There is high comorbidity between reading disability and
mathematics disability. The neuropsychological assessment
indicates that in both these conditions, there are defects
in working memory, processing speed and verbal
comprehension. In children with specific reading
disorder, there are deficits in phoneme awareness and naming
speed. Specific disorder of arithmetical skills is
associated with defects in set shifting [11].
Associated Problems
Many children with SDDSS develop somatoform disorders. They
present to clinicians with medically unexplained symptoms.
Management of the patients with medically unexplained
symptoms become a difficult problem for clinicians [12].
Their symptoms will subside only after managing the
underlying stress. Academic pressures
and learning difficulties lead to pain disorder
and conversion disorders [13]. Stress related
disorders are common during examination period in children
with SDDSS. Children with high stress level during the
period of examinations develop associated musculoskeletal
symptoms [14].
There is significant overlap between SDDSS and attention
deficit hyperactivity disorder. Attention-deficit
hyperactivity disorder has high comorbidity with SDDSS
during childhood and the reported rates of comorbidity
varies from 10% to as high as 60% depending on the sample.
These comorbid problems will cause significant negative
impact in scholastic performance [15]. Children with reading
disorders usually have comorbid behaviour disorders and
anxiety disorders. Hence early interventions for children
and adolescents with reading disabilities are of profound
importance [16].
Treatment
Intensive individualized one to one remedial training is the
treatment of choice for learning disorders. The emotional
and academic problems of children with specific
reading disorders are significantly high and hence
evidence-based interventions are essential [17]. One to one
reading interventions for elementary students at risk for
reading disabilities are found to be highly effective [18].
A very important review of the research literature conducted
by the National Reading Panel in the year 2000, gives
results about the effectiveness of different types of
interventions in management of reading disorders. The review
shows that the most effective training for improving reading
and spelling skills is systematic instructions to learn
letter sound relations and blending sounds to form words
[19]. By applying these skills in reading and writing
activities, we can definitely improve the literacy skills of
children. In children with reading disorders, there is
significant improvement in reading ability after about 70
hours of remedial education. The comprehension skill,
phonetic skill and word identification improve with remedial
training [20]. Though severe reading disorders are a major
concern, even mild deficits in reading skills, will cause
difficulty in learning. Hence even the minor deficits should
be identified early and intervention should be provided [4].
The therapy for reading disorders should include training
for improving speed and accuracy
of reading sentences and passages along with
isolated words [21].
Interventions can be started at preschool age to help
children who are at-risk for developing SDDSS. Scientific
intervention programs significantly improves the mathematics
proficiency of at risk first graders with limited number
knowledge [22
]. After Grade
one, comprehension interventions are associated with better
effect for children with specific reading disorder. Hence
developmental understanding of reading remediation
is very important [23]. Improvement in reading,
spelling and comprehension skills occur when the intensity
and duration of instructions is increased [24].
Specific remedial training for children with
mathematical disabilities will reduce the exam related
anxiety, school phobia and academic stress [25]. Remedial
intervention improves the subtraction and addition
skills of children with specific disorder of arithmetical
skills [26]. Virtual manipulative instruction is an
effective technology to teach advanced mathematical concepts
to students with specific disorder of arithmetical skills
[27
].
It is essential to find the reason for a child's scholastic
backwardness and start remedial education at the earliest so
that the child can perform up to full potential in future
[28].
Conclusion
There is an urgent need to improve awareness among teachers
and parents that, all children with scholastic backwardness
need early evaluation and scientific interventions. The
emotional and academic consequences of specific
developmental disorders of scholastic skills will have
significant negative impact in adolescence and adult life.
Several studies have proved that reading, spelling and
arithmetical difficulties can be ameliorated with remedial
training. Hence we should start the interventions at the
onset of learning difficulty. Thus we can remedy the
learning problems and guide the children towards a
successful future life.
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