LEARNING DISABILITY

Learning disability is a wide topic and is a group of many features. So I have described it in 2 posts. Most of us are aware of LD.However we may not be very clear on the same.I have tried my best to explain few concepts in brief so that it gives a clear picture. This article will give you a clear explanation on,

1. Definition of LD
2. Etiology
3. What constitutes learning disability and what is not

The next post will contain details on each of the clinical features of LD


DEFINING LEARNING DISABILITY
According to the Individuals with Disabilities Education Act (IDEA), LD is a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction.


ETIOLOGY
The human brain begins growing in the 4th week of pregnancy at a rate of over 4,000 cells per second. Unlike an adult, the fetus does not have a functional blood brain barrier to protect itself from toxic insult. This lack of natural defense allows chemicals into the fetal brain with potential to cause serious harm and disruption in this delicate brain growth process.
Scientists and researchers have now confirmed in a number of research studies that children with learning disabilities exhibit at least one of several types of damage to the brain structure. This can appear as either one or more of the following:

* Fewer numbers of brain cells in important areas of the brain
* Smaller size of brain cells
* Brain cells that migrated to the wrong part of the brain (called dysplasia)
* Lower than normal blood flow to specific areas of the brain
* Brain cells that metabolize glucose (the brain's primary fuel) at lower than normal levels

The above provides a neurological explanation for "WHAT" has actually happened inside the brains of the learning disabled, however, it does not address the question as to "WHY" it has happened. The question of "WHY" is still under research.

WHAT IS LEARNING DISABILITY AND WHAT IS NOT?

A learning Disability is what one see as wrong from the outside. That is, a child that can not read, write, do math, or run properly among their peer group is a learning disabled child. At the same time if a child has a stroke and ends up with deficits like a learning disability, we don't call it that, even though it may look exactly like a learning disability. Learning disabilities can be strongly inherited.

Even i had the same confusion on how to conclude it as Learning Disability during my study period,when one of my tutors explained it to me in such a way that i still remember it. Let me share it.

X is 8 years old. He can not read. He knows his letters, but still lags behind in reading. He also is poor in maths. He is clumsy than most children his age. His memory is not that good. His writing is very poor. There is nothing that X does to what a person would expect from an 8 year old boy. He has always been behind, and he is a very slow learner.
This is the feature one sees in mental retardation. That is, X is poor at reading, but he is not worse at reading. I would not say that X has a learning disorder.

Y is also 8. He can not read either. He knows his letters, but when he reads he reads backwards, skips lines, and can't understand how words are organized on the page. He is good in math, loves to build things, is a good drawer and is on two sports teams.
Y has a learning disorder in reading. He is of average intelligence and his reading is much worse than a person who is of average intelligence.

Z is also 8. She can not read in school, however her mom swears she can at home. She knows the letters and sounds, but doesn't pay attention to what she is doing. She has a hard time paying attention to other things, too. She is interested in fishes. Once she found a book about fishes that she was very interested in reading, she read it without problem.
Z has Attention Deficit Disorder.She has no problem reading, if she can pay attention.

I hope the examples cited above would have cleared the confusion on when to call it Learning Disability

RSI- A bane for IT folks

BEWARE OF RSI

A recent work published by Capers Jones, chief scientist emeritus of
the Software Productivity Research (SPRI) cited that there are 15 million IT
professionals worldwide.I think there is no harm in calling it an 'IT world'.

People working in the IT industry are subject to same posture or movement throughout their work time.Most of the time the work involves staring at the monitor and using the keyboard and mouse for longer time frame without rest and they are ideal candidates for RSI. .Its nothing but repetitive strain injury. It is especially important for IT professionals and people who use computers for longer time periods to know about RSI.

The term "repetitive strain injury" is most commonly used to refer to patients in whom there is no discrete, objective, pathophysiology that corresponds with the pain complaints. It may also be used as an umbrella term incorporating other discrete diagnoses that have (intuitively but often without proof) been associated with activity-related arm pain.

The first sign of RSI is unlocalised pain in the arm during work which relieves after a short break but again appears on work. Many people neglect the indicating sign.This on progression leads to numbness and tingling sensation in the arm.Finally it leads to muscle fatigue and lack of endurance.

The symptoms of RSI if given importance at the very beginning,can be prevented by making modifications in the work posture, minor adaptations in the work station, altering the work routine by giving regular breaks in between and so on. When we come to see about the prognosis, almost all suffers of RSI improve on following proper ergonomic principles in work station and other recommended therapies.

To conclude, IT people are committed when it comes to work. However the same is not true in looking after their health and fitness.A few modifications to the way they work and some good workplace ergonomics would improve healthy work performance.

HOME PROGRAM IN OCCUPATIONAL THERAPY

Occupational therapy as you all must have known is a part of rehabilitation program that incorporates active participation of the clients in the process. The therapist explains the purpose of an activity and simulates it for the client and remains passive for the rest of the time. The client is encouraged by the therapist in every way for his/her progression. As long as the client comes to the department, they work with the therapist instructing by their side. But nobody wants to continue their department visit lifelong. So after a period of regular visits, the clients are given follow up schedule and are asked to visit the department once in a while.

It is here where HOME PROGRAM plays a main role. The therapist creates a home program for the client.
What is home program all about?
As an Occupational Therapist let me explain this to you...


It is a detailed Therapy program given to the clients to do at home till they visit the department next time. The therapist prepares the home program in such a way that the clients can do it successfully with the things available at their home.
Home program includes list of symptomatic activities (i.e.) activities according to the clients symptoms, the frequency of intervals in which they have to be performed and activity progression according to the clients improvement level. The above mentioned are the highlights in a Home Program without which it is incomplete. The therapist explains it in detail for the client and asks for any clarifications. The client is given a detailed picture about the importance of home program.

The clients on performing the home program as per the therapist's guidelines feel the rate of improvement in their skills during their follow up visit. This serves as a strong source of encouragement for the client in achieving their end goal which in turn helps the therapist to proceed on.

I hope I’ve given a clear outline on what home program is all about. Occupational Therapy is a cluster of many such concepts which when explained, makes a lot of sense. Occupational Therapists as a rehab team member create a client-friendly environment and helps out their client to achieve a near normal life.