In recent years, hospitals in major cities have opened specialized clinics for "learning difficulties", and it has become a common practice that "it is difficult to get an appointment". Is "learning difficulties" a disease? Why do we have "learning difficulties"? Is the "attention deficit hyperactivity disorder" we often talk about related to this? In life, children's "learning difficulties" are reflected in poor learning status, slow homework, poor grades, and dislike of going to school. Parents and teachers are most likely to discover such learning-related problems. In fact, behind this problem, there are comprehensive problems in various aspects such as disease and family. This is why the hospital has set up a special "learning difficulties" clinic. Strictly speaking, "learning difficulties" are not a disease, but just a clinical phenomenon. In medical diagnosis, there are four main possible causes of "learning difficulties": 1. Specific learning disabilities; 2. Attention deficit hyperactivity disorder ("ADHD"); 3. Developmental delay (mental development disorder); 4. Autism spectrum disorder (autism). Among the above four reasons, there is "ADHD" that we often hear in life, but what exactly is "ADHD"? What are the specific learning disabilities in the above reasons? How do they cause "learning difficulties"? What are the lasting effects? How to treat them correctly? The following article will discuss these issues. What are ADHD and Specific Learning Disabilities? The full name of "ADHD" is Attention Deficit/Hyperactivity Disorder (ADHD), which is the most common neurological and mental developmental disorder in children. Its main clinical manifestations are: (1) obvious and persistent inattention; (2) high energy and excessive activity; (3) impulsiveness, etc. Impulsiveness, hyperactivity, learning problems, and conduct problems are the most prominent behavioral problems in children with ADHD. Generally speaking, the symptoms of hyperactivity and impulsivity are more obvious in younger children, and the symptoms of attention deficit become more prominent as they grow older. ADHD symptoms are generally easier to identify in elementary school. Some children with ADHD have poor verbal and written expression skills or cognitive function defects, accompanied by learning difficulties, poor interpersonal relationships, and low self-esteem. Learning Disorder (LD) refers to a serious defect in learning that is lower than that of the average peers, and the defect cannot be fully explained by the environment or other psychological problems, and cannot be attributed to mental retardation, vision and hearing problems, motor disorders, etc. LD is often associated with skills that need to be learned and practiced in school (such as reading, mathematics and writing), so LD is mainly divided into dyslexia, mathematical disorders and dysgraphia. LD may only occur in a certain skill area. For example, a child with math disabilities finds it difficult to understand math, but if it does not involve calculations and problem solving, he is no different from an ordinary child. He may even have strong ability in reading text. Therefore, the more standardized diagnostic name for learning disabilities is Specific Learning Disorder (SLD). In contrast, intellectual disability refers to deficits in overall cognitive abilities, while children with specific learning disabilities do not have general intellectual impairments. How do ADHD and Specific Learning Disabilities cause learning difficulties? Lack of concentration and easy distraction is a major cause of learning difficulties for teenagers, which is also one of the symptoms of ADHD children. For example, ADHD children always procrastinate when reading a text and often get distracted and make small movements in the middle. If the child can do well after being effectively supervised and motivated, then his condition is not very serious and the child can perform like his peers as long as he is given enough time and proper supervision and guidance. However, some children with ADHD have lower learning abilities than healthy children in dimensions such as math problem solving, reading comprehension, and word discrimination. They also have problems with memory and organizational skills. Therefore, children with ADHD may also have specific learning disabilities such as dyslexia and written disabilities, which in turn aggravate the occurrence of "learning difficulties." Academic and family stress can exacerbate symptoms For teenagers, interpersonal relationships and academic pressure are their main stressors. According to the Education Blue Book: China Education Development Report (2018), among the reasons for primary and secondary school students' suicide, family conflicts accounted for 33%, ranking first, and the second largest reason was academic pressure, accounting for 26%. However, the root cause of conflict in a considerable number of family conflict cases is also academic pressure. Considering the indirect effect, the report believes that academic pressure is the primary cause of primary and secondary school students' suicide. The academic pressure on children at a younger age is generally lighter, and in this case, the learning function defects of ADHD children may not be prominent and are not enough to cause significant academic performance lag. However, as the learning tasks become heavier and the requirements for multiple cognitive functions increase, such as the increase in the difficulty of learning subjects after entering middle school, the probability of ADHD children experiencing "learning difficulties" will increase. Family pressure may come from strained parent-child relationships caused by "learning difficulties" or parents' excessive expectations of their children. Studies have shown that family relationships, atmosphere, and even neighborhood relationships are risk factors for mental disorders in children and adolescents (referring to mental illnesses with varying degrees of impairment in cognitive, emotional, behavioral, and volitional mental activities, including but not limited to ADHD). Strong family support is a key factor in reducing the prevalence of mental disorders in children and adolescents. The lasting effects of ADHD and specific learning disabilities In daily life, children with ADHD and learning disabilities are easily scolded, criticized, and even isolated in class. If they do not seek medical treatment and receive correct guidance in time, and continue to be exposed to negative comments for a long time, the children will continue to accumulate frustration, become inferior, and may even develop other psychological problems (such as depression, anxiety, etc.), which is very detrimental to the healthy growth of children. As for the problem of "learning difficulties", it is not just the children themselves, but also the parents' body and mind that are easily troubled. For example, they become irritable because they cannot understand the performance of their children's "learning difficulties", and fall into painful struggles after their children are diagnosed with ADHD or SLD. They may pay more attention to their children's academic performance and worry about their children's health for a long time, and their mental health will deteriorate, and they are prone to depression, anxiety and other symptoms. How to deal with ADHD and learning disabilities? Early detection and early treatment, facing it with a positive attitude The current treatment for children with ADHD is mainly divided into three aspects: psychotherapy, behavioral intervention and drug therapy. It is necessary to follow the doctor's advice and receive scientific treatment. Early detection and scientific treatment can help control and improve core symptoms, and enable children with ADHD to improve their learning, social, behavioral and other skills. At present, the diagnosis of specific learning disabilities is mainly based on observing and recording the child's daily performance, and conducting auxiliary assessments when necessary, including intelligence tests, reading assessments, etc., combining daily performance and auxiliary assessments to make judgments. After the diagnosis is confirmed, the child is mainly helped to gradually recover through scientific reading, writing and other training. Focus on building family relationships and accompany children as they grow. Targeted correction of children's behavioral problems is one of the effective measures to treat SLD and ADHD and alleviate the symptoms of learning difficulties. For example, parents can help children with dyslexia by marking reading points, guiding their children to understand with the help of specific things such as pictures, etc., and regulate the learning behavior of children with ADHD by agreeing with their children to focus on their respective tasks and setting an example themselves. It is important to emphasize that behavior correction should be implemented in daily life, which means that family relationships and family education are crucial to children's recovery. Parents should correctly understand their children's illness, learn how to communicate with them, give their children the right response and support, and help their children fight the disease by establishing a good family relationship. References: [1] William G Kronenberger and David W Dunn. Learning disorders[J]. Neurologic Clinics, 2003, 21(4): 941-952. [2] Goker Z. Clinical and Sociodemographic Features of Children and Adolescents with Specific Learning Disorder (SLD)[J]. American Journal of Psychiatry and Neuroscience, 2014, 2(6): 90. [3] Liu Yuxin, Wang Yufeng. Comparison of cognitive characteristics of children with attention deficit hyperactivity disorder with and without learning difficulties[J]. Chinese Journal of Psychiatry, 2002(04):31-34. [4] Ma Jia, Li Zhiyong, Song Ping, et al. The impact of children's hyperactive behavior problems on learning disabilities and cognitive structure[J]. Chinese Journal of Behavioral Medical Science, 2005(10): 939–940. [5] Wang Shengxing, Xu Ying, Xia Wei. A study on the mental health, self-esteem and coping style of parents of children with mathematical learning disabilities[J]. Chinese Journal of Behavioral Medical Science, 2006(07): 650–652. [6] Zhao YX, Zheng Y. Progress in epidemiological research on child and adolescent mental disorders[J]. Chinese Journal of Psychiatry, 2014, 47(3): 186–189. [7] Dong Min, Wang Yufeng, Qian Qiujin. Characteristics of learning ability in children with simple attention deficit hyperactivity disorder[J]. Chinese Journal of Psychiatry, 2018, 51(02): 118-124. [8] Education Blue Book: China Education Development Report (2018) Medical review: Wang Fang, attending physician of the Department of Psychiatry, Beijing Children's Hospital, Capital Medical University |
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