By Karen J. Miller, MD
Charlie looks around his first grade classroom when it’s reading time. He needs frequent reminders to get back to work. His teachers and his parents are puzzled why such a bright boy is having trouble in school. Could it be an attention deficit causing the problem? Could a learning problem cause the inattention? How can they help Charlie succeed?
Learning and attention problems are common and can range from mild to severe. From 5 to 10% of school-age children are identified with learning disabilities (LD). At least 5 to 8% are diagnosed with Attention-Deficit/Hyperactivity Disorder (AD/HD). Many of these children have both. Although the studies vary, 25 to 70% of children with AD/HD have a learning disability and from 15 to 35% of children with LD have AD/HD. There are many children who have milder learning or attentional problems but the additive effects can be significant. Even mild dysfunctions in these critical brain functions can create problems as demands increase in secondary school, college and in life.
Attention and learning are related brain processes, separate but dependent on each other for successful functioning. “Learning” is the way the brain uses and remembers information like a factory taking in raw materials, storing parts and then manufacturing and shipping a finished product. “Attention” involves brain controls which regulate what information gets selected as important and gets acted on.the attention/behavior control system acts like the executives at the factory distributing the “brain energy” budget, setting priorities, deciding what to produce and monitoring quality control. Late shipments or poor quality products could be the result of any number of “glitches” in either system. Minor problems in one system can be compensated for but when both systems are affected failure looms. Sorting out the breakdown points is critical but can be complicated.
Evaluation: Look Beyond Symptoms
Comprehensive assessment is needed as some of the symptoms of learning and attention problems may look similar, at least on the surface. A child may be “distractible” because weak attention controls are unable to filter out unimportant sights or sounds. However, if reading is too difficult the child may look around because it doesn’t make sense. A child might be “disruptive” because their behavior controls are weak and they impulsively call out or annoy others. Some children with learning problems may act-up out of frustration or embarrassment. They would rather be considered “bad” than dumb. Other difficulties that can occur with either learning or attention problems might be:
- Underachievement despite good potential
- Inconsistent concentration
- Difficulty with time-limited tasks
- Problems with starting/completing work
- Messy writing or disorganized papers
- Low self-esteem
- Problems with peer relations
- Behavior problems
- Secondary emotional problems due to repeated failure and frustration