Intelligence testing/Aptitude tests/Learning disability

In depth discussion of Learning disability, Mental retardation

The child presented in the vignette has good reading and listening skills, but has difficulty with written expression, as revealed by a significant discrepancy between his performance intelligence quotient (IQ) and written expression scores. Achievement tests provide a norm-referenced profile of the child's academic skills compared with children of the same age. A subnormal score on an achievement test with a normal performance IQ is most likely due to a specific learning disability. Children who have difficulty with written expression often do well in the early grade school years because there is minimal reliance on written language. As the demand for written output increases with each school year, though, these children often become frustrated, and their achievement decreases.

A learning disability is evaluated by comparing achievement test scores with IQ test scores. The most commonly used achievement tests in the educational system are the Wechsler Individual Achievement Test (WIAT), the Wide-Range Achievement Test, Revised (WRAT-R), and the Woodcock-Johnson-Revised (WJ-R). The WIAT correlates with the Wechsler Intelligence Scale for Children, Third Edition (WISC-III), a test of cognitive ability.

The higher reading comprehension score of the boy in the vignette makes a visual impairment and lack of effort unlikely sources of his problems. It also discounts the probability that a perceptual-motor impairment (eg, difficulty copying written language or numbers) is contributing to his difficulty with written expression. His headaches are likely due to stress-related performance pressures, not migraine.

There are many strategies for managing a learning disability to assist children in achieving academic success. A child's educational strengths and weaknesses should be explained to the family to demystify the diagnosis. Strategies can be devised to circumvent weaknesses in some classroom settings while remediating skills in other settings. The curriculum can be modified to avoid overburdening the student's skills with too many classes at one time in his or her area of difficulty. Areas of strength should be reinforced to maintain self-esteem and motivation.

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