Behavioral, emotional and social aspects of the Learning Disabled

Dr. Kersi Chavda Psychiatrist, P .D. Hinduja National Hospital

After the 1980s there has been a change in focus from only looking at academics of the LD child to evaluating his social, emotional and behavioural aspects

We know that the majority of preschoolers with dyslexia are happy and well-adjusted. However emotional problems seem to begin when early reading instruction does not match their learning styles

Frustration centres on their inability to meet

expectations of others as well as inability

to achieve their own goals

The emotions of bewilderment, shame and guilt

of being inadequate deals a crippling blow to

confidence and self-esteem Early on in life starts a feeling of inadequacy and impotence a feeling that he would not be able to manage things and will NEVER get them right

This feeling tends to persist in adulthoodone often avoids challenges, refuses promotions, etc. Often the feeling: Am I good enough?

A child is likely to be having BES difficulties if his behaviour

Is not age- appropriate Results in isolation from his peers Negatively affects the learning environment Places unreasonable demands on the teaching staff Leads to negative self-concept and a low selfesteem Creates dangerous situations

Pupils with BES behaviours are troubled individuals whose emotional state leads them to negative behaviours. They may seek attention, even the negative kind, or lash-out at a world wherein they feel that everyone is against them.
This results in a serious lack of positive feedback in a downward spiralling of self-esteem The child becomes his worst enemy

Social Competence
This refers to the social, emotional and
cognitive skills and behaviours that

children need for successful social

adaptation

This depends on a number of factors including social skills, social awareness and self-confidence

Whereas parents are the primary source of social

and emotional support for children during the

first years of life, in later years peers play a significant complimentary or unique role in promoting child social-emotional development. With increasing age, peers rather than parents

become preferred companions

Children learn to take another persons perspective and develop an understanding of the social rules and conventions of their culture. There is more give and take between them than with adults.. thus providing an opportunity for the development of social competencies such as cooperation and negotiation. These skills are associated with effective interpersonal relationships in adult life, including with co-workers and romantic partners

Social skills
This is the knowledge and ability to use a variety of social behaviours that are appropriate to a given inter-personal situation and are pleasing to others It is the capacity to inhibit egocentric, impulsive and negative social behaviours

A childs social effectiveness is an ability to

establish and maintain high quality and mutually

satisfying relationships and to avoid negative

treatment or victimization from others

Why are youth with LD less accepted by their peers?

# Poorly developed social-emotional skills may be responsible (Bryan 2002) # Poor language and communication skills # Difficulty recognizing and understanding others emotions # Co-morbid psychiatric disorders e.g.. ADHD and depression # Educational isolation # Repeated failure and low self-esteem

The possibility of bidirectional pathways between both disorders has also been proposed (Hinshaw 1992) Thus : Anxiety Cognition Failure

There appear to be five main ways in which emotional concerns and Learning

Disabilities interact:

* LD leads to emotional distress * LD raises or exacerbates existing emotional concerns * Emotional issues may mask a childs LD * Emotional issues may exacerbate an LD * Positive emotional health may enhance the performance of children with LD

LD may lead to emotional stress

# There are increasing levels of depression, loneliness and low self-esteem (Livingston.1985). # It is unclear as to whether depression worsens LD or LD puts children to increasing risk of

depression, or whether an overreacting brain

dysfunction increases the likelihood of both

# There is often increased victimization

# There is increased anxiety {Margalit and Zak

1984} the LD child feels more often that events happening to them are beyond their control # Bender and Wall (1997) :There is an increased

co-morbidity of LD and depression

Forness and Karale (1999): Nearly I out of every 4 depressed children seemed to have an LD

There are attempts to cope with a difficult learning process and the resultant failure, frustration and feelings of incompetence that these feelings cause

# Impulsivity and low self esteem and a cognitive

weakness in relating cause and effect may

increase suicide risk above the risk of depression alone.

# Thus, some of the very characteristics of LD may predispose them to suicide (Rouke 1996)

LD exacerbates existing emotional concerns:

# The disability influences the childs ability to develop positive interpersonal relationships # There are more problems with social incompetence # There is increased sadness, confusion and anxiety

The incidence of anxiety and depression in LD children seems to cause Oppositional Defiant Disorders , Conduct Disorders and Adjustment Disorders of Adolescent much more than in the normal population

Behavioural problems in LD are not

necessarily an indication of emotional

disturbances but may be part of the neuro-

developmental delays associated with this

condition

# There is an increased vulnerability to drug and alcohol abuse

# The is an increased likelihood of being a school drop-out

Emotional issues may mask LD

# There may be a focus on a childs demeanor or actions with no realization that LDs are present # There may be an increase in somatic complaints # There may be acting out behaviours: a turning

of hatred onto selfprovoking reproach from

others

Emotional health may intensify LD

# Abrams(1986): Constant failure and frustration may lead to strong feelings of inferiority which in turn may intensify the initial LD # Escaping school # Trouble at home

Emotional health may enhance performance of students with LD

Bryan (1996): Positive affective states increase performance of memory, computation and discrimination # Learning about their own LD seems to help # Cognitive therapy : helps can-do attitude

There are clear indications that understanding

the different mechanisms of interaction can be

helpful in selecting priorities and strategies for

interventions

Helma Myklebust et al (Chicago, Ilinois,2005) :

394 public school children: explored the

relationship between emotional disturbance and LD 226 III and IV graders, 170 boys/156 girls with clearly diagnosed LD were compared to a

control group of 168 kids

Factorial analyses of variance disclosed that

children with LD exhibited greater emotional

stress on only 4 out of 14 scores of the Children's Personality Questionnaire. Despite marked differences in verbal learning and cognitive functioning, they were comparable

to normal children in emotional status

It is suggested that deficits in social (nonverbal} perception may be more critical to

the onset of autism

Another perspective:
Kids with LD often land up experiencing /exhibiting a number of characteristic features:

SHAME
For some kids who are diagnosedthere is a sense of relief. For others, this causes further stigmatization.
This often causes the individual to hide the

difficulty rather than risk being labelled.

Internalized negative labels of stupidity and incompetence usually result in a poor self-concept and lack of confidence (Gerber and Ginsberg,1992)

FEAR
This is often masked by anger and anxiety Fear:.of being found out They develop coping strategies to hide their disability Fear of failure:.. They reason that since they failed before, they will fail againso they perceive themselves to be failures

Fear of ridicule: Adults internalize the negative criticisms and view themselves as dumb, lazy and incompetent

Fear of rejection: ..if not seen as capable by others

Environmental and Emotional Sensitivity

Adults are often overwhelmed by too much environmental stimuli e.g.. background music, side-conversations, etc. They are often believed to be highly sensitiveoften unable to cope with the onslaught of the emotions that they feel

Emotional regulation
LDs shift easily from one emotion to the next. Others may experience difficulty regulating impulses or actions

CHANGE
There is often difficulty adjusting to change

They are less prepared for the unexpected!

What can be done?

The negative behaviours often seen in a child with LD and ADHD often seem to turn into positive attributes

in adulthood. List carefully the irritating negative

behaviours in your students and imagine which ones may eventually contribute to adult success

What happens in childhood as a refusal to

do things the same way that others do

them is really an inability to perform the

same way. The child has to find a way to

solve the problemsin his own original

manner, an original way

Students who are rigid and work with great

intensity as children are committed and

dedicated with highly focused

thinkinge.g. researchers

Kids who are highly ego-centric and self-

absorbedoften translate into creative and

highly successful activitythe artist, the

novel thinker and the popular critic

A number of LDs who tend to be friendless and isolated from groupsland up working for the homeless, elderly or illpopulations which desperately need assistance

Harvard psychologist, Dr. Howard

Gardner, says most schools rely on

linguistic intelligence, the world of words,

or mathematical logical intelligence, the

world of numbers and logic.

Alternative learners frequently use their

visual intelligence (artists, film makers0, or

musical intelligence (musicians), or

kinesthetic intelligence (dancers and

athletes)

Gardner also describes those who have interpersonal intelligence (great leaders and entrepreneurs) or intrapersonal intelligences (psychologists and social workers). Some learn through nature (zoo keepers and explorers).and many more.
Parents and teachers need to look for these routes and bring them to schools

Remediation must find a way to reverse the

cycle of failure and to experience success,

build feelings of self-worth and increase

confidence

Individual therapy could be effective when introduced in conjunction with special ed. provisions. However, group therapy may be more effective as peers are a better source of

support and insight, specially peers who have

the same problems. While insight is gained in individual therapy, it can be exercised in the safe

environment of a supportive small group

Testing the negative thought, and often realizing it is wrong. e.g. I am dyslexic it must be my

fault again or I never get anything right.

Exercise.structured physical activity

Relaxation exercisesguided visual

imagery

Helping a child develop a sense of commitment, control

and challenge may be useful while coping with the stressful circumstance.

Commitment
The committed find the learning situation more meaningfulideally they are actively involved in building their special educational programme.

Control
They behave and act as if they can influence the course of events. They perceive many stressful life events as predictable consequences of their own activity, and thereby, as subject to their own

direction and manipulation

Challenge
This is a belief that change, rather than stability, is normal. Stress then is anticipated as an opportunity and incentive for growth

Mother Theresa: We will never know till we go to heaven how much we owe the poor for allowing us to help them. The truth she spoke lies in the basic need of human beings to do something useful and helpful to others if one is to be truly fulfilled and happy.

As the LD student acquires the skills of helping others, they discover more of their own resources, and feel more related to the world because others need them. They are empowered by giving.

Do not give up hope

There is outstanding resilience in many

unlikely students and there are numbers of

good people who help them with their

difficult journeys to adulthood.

Do not discount the impossible

Some very irritating negative behaviours that have worn out parents and teachers and lead to school failure, have helped youngsters with LD demonstrate astonishing creativity and awesome talent in adult life.

Different is not bad.

Different is the world.

Thank you