Behavioral, emotional and social aspects of the Learning Disabled

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Behavioral, emotional and social aspects of the
Learning Disabled

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

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• 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

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• 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

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• Frustration centres on their inability to meet
  expectations of others as well as inability to
  achieve their own goals

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• 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

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

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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
  self-esteem
• Creates dangerous situations

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• 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

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Social Competence

• This refers to the social, emotional and
  cognitive skills and behaviours that children
  need for successful social adaptation

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

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• 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

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• 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

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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

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• 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

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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

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

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

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• 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

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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

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• 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

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

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

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• 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)

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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

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• 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

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• 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

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• There is an increased vulnerability to drug and
  alcohol abuse
• The is an increased likelihood of being a
  school drop-out

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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

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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

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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

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• There are clear indications that understanding
  the different mechanisms of interaction can be
  helpful in selecting priorities and strategies
  for interventions

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• 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

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• 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

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• It is suggested that deficits in social
  (non-verbal perception may be more critical to
  the onset of autism

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Another perspective

• Kids with LD often land up experiencing
  /exhibiting a number of characteristic features

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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.

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

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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

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• 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

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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

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Emotional regulation

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

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CHANGE

• There is often difficulty adjusting to change
• They are less prepared for the
  unexpected!

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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

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• 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

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• Students who are rigid and work with great
  intensity as children are committed and dedicated
  with highly focused thinkinge.g. researchers

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• Kids who are highly ego-centric and
  self-absorbedoften translate into creative and
  highly successful activitythe artist, the novel
  thinker and the popular critic

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• 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

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• 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.

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• Alternative learners frequently use their
  visual intelligence (artists, film makers0, or
  musical intelligence (musicians), or kinesthetic
  intelligence (dancers and athletes)

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• 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

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• Remediation must find a way to reverse the
  cycle of failure and to experience success, build
  feelings of self-worth and increase confidence

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• 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

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• 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.

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• Exercise.structured physical activity

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• Relaxation exercisesguided visual imagery

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• Helping a child develop a sense of
  commitment, control and challenge may be useful
  while coping with the stressful circumstance.

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Commitment

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

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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

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Challenge

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

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• 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.

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• 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.

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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.

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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.

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• Different is not bad.
• Different is the world.

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• Thank you