Phoniatric evaluation: relationships between a set of tests and academic difficulties

Abstract Introduction: Learning disability has a significant relevance and can generate negative social impacts on the future of an individual if not corrected in time. Phoniatrics is an area of otorhinolaryngology responsible for evaluating, diagnosing, and referring these cases for therapy and/or complementing the multidisciplinary diagnosis. Objective: To evaluate in school-aged children the association between the application of a set of tests used in the phoniatric assessment and complaints of academic difficulties. To identify which tests would show the main association with academic performance when applied individually. Methods: Blind, cross-sectional study, subdivided into 4 stages. In the 1st stage, 66 children in the third year of elementary school were submitted to the set of tests of skills applied by the phoniatrician; in the 2nd stage, the physician asked the educators about complaints of academic difficulties regarding the students; in the 3rd stage the students' Portuguese language school grade was obtained and in the 4th stage an analysis was made between the data. Results: The educator identified complaints of academic difficulties in 27.2% of the 66 students. There was a statistically significant association between academic difficulties and the following tests of skills: dictation of words and pseudowords, dictation of words, dictation of pseudowords, rhyming, phonemic synthesis, and in the reading test; fluency, intonation and comprehension of the text and morals were analyzed in the reading test. In the multivariate logistic regression analysis, the tests selected to comprise the final model, showing greater association with the academic difficulty complaint were: dictation of words, intonation in reading and comprehension of the morals of the story. Conclusion: The tests identified as the most relevant in identifying academic difficulties were dictation of words, intonation in reading and comprehension of the morals of the story. However, the other tests that were part of the phoniatric consultation allowed the observation of the individual and their functioning abilities, leading to a better assessment of the case, regarding aspects not directly related to the pedagogical one.

Funções executivas em crianças que apresentam dificuldades de aprendizagem / Executive functions in children with learning disabilities

As Funções Executivas (FE) podem ser definidas como um grupo complexo e integrado de recursos cognitivos que permitem ao sujeito efetuar comportamentos voltados a fins previamente decididos. Alterações nessas habilidades, preditoras de uma boa prática acadêmica, podem desencadear dificuldades no processo de aprendizagem de crianças. Logo, objetivou-se apurar a relação entre FE e dificuldades de aprendizagem em crianças com idades entre 7 e 11 anos de ambos os sexos, atendidas em um centro especializado nessa demanda para o público infantil. Foram utilizadas as ferramentas Five Digit Test(FDT) e um questionário sociodemográfico para a coleta de dados. Foram feitos estudos estatísticos descritivos e correlacionais por meio do software SPSS para Windows, a partir dos quais descrevemos correlações significativas entre os componentes executivos 'Controle Inibitório' e 'Flexibilidade Cognitiva' e as dificuldades de aprendizagem, o que nos indica a importância destes para a execução acadêmica, bem como a relevância de métodos de avaliação das FE na primeira fase escolar, para assim prevenir/minimizar o impacto dessas dificuldades no curso do aprendizado. Pontua-se que foram descobertos impasses normativos para correção de erros no teste aplicado, criando limitações na pesquisa, assim, propõe-se uma ampliação de normatizações.

Executive Functions (FE) can be defined as a complex and integrated group of cognitive resources that allow the subject to perform behaviors aimed at previously decided ends. Changes in these skills, predictors of good academic practice, can trigger difficulties inthe learning process of children. Thus, the objective was to investigate the relationship between EF and learning difficulties in children aged between 7 to 11 years of both sexes, attended at a specialized center in this demand for children. Five Digit Test (FDT) tools and a sociodemographic questionnaire were used for data collection. Descriptive and correlational statistical studies were carried out using PSS for Windows software, from which we describe significant correlations between the executive components 'Inhibitory Control' and 'Cognitive Flexibility' and the learning disabilities, which indicates the importance of these for academic performance, as well as the relevance of EF assessment methods in the first school phase, in order to prevent/minimize the impact of these difficulties on the learning course. It is pointed out that normative impasses were found to correct errors in the applied test, creating limitations in the research, thus, an expansion of norms is proposed.

Analysis of Functioning and Design of Individualized Rehabilitation Protocol for Children with Learning Disability Using ICF / 中国康复理论与实践

Objective To analyze the overall functioning of children with learning disabilities, and develop individualized exercise rehabilitation protocol using International Classification of Functioning, Disability and Health (ICF). Methods Based on the theoretical framework of ICF and the disease diagnosis of International Classification of Diseases (ICD-11), and with the perspective of child development, the functional profiles of cognition, understanding, attention, thinking, motor, and activity and participation of children with learning disabilities were analyzed. A function-oriented and individulized exercise rehabilitation protocol for children with learning disabilities was constructed in light of ICF bio-psycho-social health paradignm and the theory of somatic and mental interaction. Results The functional performance of children with learning disabilities mainly demonstrated in mental dysfunction in physical functioning in the activities and participation limitations, such as learning and applying knowledge, general tasks and demands, and communication. For the environment factors, products and technology for education, products and technology for culture, recreation and sports, and services, systems and policies could also affect children with learning disabilities. Physical activity was beneficial for children with learning disabilities to improve mental and motor functioning and to effectively enhance intellectual, cognitive, attentional, communication, and mobility skills for the overall development of the children. Physical activity for children with learning disabilities was selected according to WHO guidelines for physical activity and sedentary behavior for children, and moderate to vigorous physical activity for at least 60 minutes, as well as high-intensity training no less than three times a week, together with appropriate physical games and leisure physical activities could effectively improve learning outcomes and reduce learning disabilities. Conclusion The health condition, functioning and motor development of children with learning disability had been analyzed using ICD-11 and ICF, and with the theories of somatic and metal interaction and ICF bio-psycho-social model, the holistic and function-oriented exercise rehabilitation program was developed that recommended at least 60 minutes of moderate intensity physical activity, including aerobic exercise and physical games, per day, and at least three times a week of high intensity physical activity of no less than 30 minutes, including plyometrics and physical competition. The development of individualized function-based exercise rehabilitation programs incorporating the learning disability and motor function characteristics of children could effectively improve the cognitive, attentional, and thinking functions of children with learning disabilities, reduce learning disabilities, and promote the overall development of children.

Analysis of Functioning and Design of Individualized Rehabilitation Protocol for Children with Learning Disability Using ICF / 中国康复理论与实践

Objective To analyze the overall functioning of children with learning disabilities, and develop individualized exercise rehabilitation protocol using International Classification of Functioning, Disability and Health (ICF). Methods Based on the theoretical framework of ICF and the disease diagnosis of International Classification of Diseases (ICD-11), and with the perspective of child development, the functional profiles of cognition, understanding, attention, thinking, motor, and activity and participation of children with learning disabilities were analyzed. A function-oriented and individulized exercise rehabilitation protocol for children with learning disabilities was constructed in light of ICF bio-psycho-social health paradignm and the theory of somatic and mental interaction. Results The functional performance of children with learning disabilities mainly demonstrated in mental dysfunction in physical functioning in the activities and participation limitations, such as learning and applying knowledge, general tasks and demands, and communication. For the environment factors, products and technology for education, products and technology for culture, recreation and sports, and services, systems and policies could also affect children with learning disabilities. Physical activity was beneficial for children with learning disabilities to improve mental and motor functioning and to effectively enhance intellectual, cognitive, attentional, communication, and mobility skills for the overall development of the children. Physical activity for children with learning disabilities was selected according to WHO guidelines for physical activity and sedentary behavior for children, and moderate to vigorous physical activity for at least 60 minutes, as well as high-intensity training no less than three times a week, together with appropriate physical games and leisure physical activities could effectively improve learning outcomes and reduce learning disabilities. Conclusion The health condition, functioning and motor development of children with learning disability had been analyzed using ICD-11 and ICF, and with the theories of somatic and metal interaction and ICF bio-psycho-social model, the holistic and function-oriented exercise rehabilitation program was developed that recommended at least 60 minutes of moderate intensity physical activity, including aerobic exercise and physical games, per day, and at least three times a week of high intensity physical activity of no less than 30 minutes, including plyometrics and physical competition. The development of individualized function-based exercise rehabilitation programs incorporating the learning disability and motor function characteristics of children could effectively improve the cognitive, attentional, and thinking functions of children with learning disabilities, reduce learning disabilities, and promote the overall development of children.

Quality of life, perceived stress and caregiver burden in mothers of children with childhood psychiatric disorders in Kerala, India

Background: Common childhood psychiatric problems like attention deficit hyperkinetic disorder (ADHD), Pervasive developmental disorder (PDD) and learning disability (LD) often co-exists with each other and form a constellation of behavioural manifestations that require extra attention from the caregivers. Having a differentially-abled child is challenging and most parents have to learn to restructure their lives around that of the child. There is a difference in the attitudes of both the parents as far as parenting a disabled child is concerned. Mothers often shoulder the primary caregiving role however the psychological costs borne by women go unrecognized. The study aims to assess the care giver burden (BOC) and perceived stress (PS) and quality of life (QOL) in mothers of children with ADHD, PDD and LD.Methods: It was a cross-sectional study with 336 child mother pairs. The mothers were asked to rate their burden and stress symptoms on the perceived stress scale and Burden of care scale. The mothers were also asked to rate their quality of life on the quality of life scale.Results: The mean PS score was highest in the PDD group. The mean BOC was lowest in the LD group. The QOL score was highest in the LD group.  There is statistically significant difference in the PS, BOC and QOL scores among the three groups.Conclusions: There is a hidden lacuna of psychological stress in mothers of children with common psychiatric problems. The study also establishes that these mothers have poorer quality of life. It is necessary to address these psychological issues of the mother at every visit and equip them with coping strategies so that they can look after both themselves and their special needs child.

Effect of remedial teaching on the scholastic performance of children with learning disability

Background: To assess the effectiveness of remedial teaching in children with learning disability and to find association between IQ score and age of the child with their improvement.Methods: An interventional study using pre-post study design, took place in Child Development Centre (CDC) of tertiary care Medical College hospital. Participants includes 45 school going children of age group of 6-15 years. After initial diagnosis and IQ assessment, remedial teaching was given in CDC for 12 months. Techniques are chosen on an individual basis by formulating individualised education program (IEP) by special educators. Diagnosis and pre- post assessment were done using tool, NIMHANS SLD battery. Effectiveness was evaluated as improvement in class levels of students. Definite improvement was decided in each student if improvement was observed in 4 or more domains.' Relationship of IQ score and age with their improvement in was noted.Results: In pretest, poor results were found in attention and copying in 39 children, reading in 41, comprehension and spelling in 42, written expression in 43, and arithmetic in 44. In posttest, good results with statistical significance (p<0.05) were found in attention in 33, copying in 27, reading in 24, arithmetic in 15, and spelling in 12 children. Definite improvement was noticed for 33% of students with significant association with age and not IQ score of the child.Conclusions: This study shows that remedial teaching can bring about significant changes in academic skills namely attention, copying, reading, arithmetic, and spelling. 33% had definite improvement in 4 or more domains. The improvement in academic skills following remedial teaching was dependent on the child's age and not on IQ score.

Effectiveness of awareness lecture in improving the knowledge about learning disability among primary school teachers

Background: This study was done to assess the pre-existing knowledge about' Learning Disability (LD) among primary school teachers and the effect of awareness lecture on improving their skills in' early identification and remediation of LD among children having poor scholastic performance.Method: The study was conducted as a part of the IAP state President's action plan 2018-2019 'VIBGYOR'. The study sample consisted of 709' primary school teachers of government schools in Malappuram district in Kerala. The teacher's knowledge level on LD was assessed using a questionnaire following which an awareness class was given. Their knowledge level was assessed again at the end of the class.Results: There is a significant increase in knowledge level about learning disability among the teachers after the awareness lecture (p value<0.001).Conclusion: This study implicates the need for intensive training programmes to primary school teachers on learning disability so as to identify it at an early stage among children with poor scholastic performance.

Assessment of knowledge level on learning disability among primary school teachers

Background: Learning disability (LD) is one of the major causes of poor scholastic backwardness. Undetected and unmanaged specific LDs result in chronic scholastic backwardness ensuing school dropouts, emotional and behavioral problems such as depression, substance abuse and social delinquency. Since teachers are the ones who first encounter academic difficulties of children, their knowledge and training on LD is of utmost importance in identifying it at an initial stage and to prevent further mental and social damage. This study is to assess the knowledge level of primary school teachers on learning disability.Methods: This cross-sectional study was conducted among government primary school teachers of Malappuram district, Kerala from April 16, 2018 to May 20, 2018.Convenient sampling method was adopted. The study sample consisted of 709 primary school teachers from 21 schools in Malappuram district of Kerala and the teacher's knowledge level on learning disability was assessed using a questionnaire.Results: Even though majority of the teachers had some knowledge about the outcome and treatment of learning disability, they lack sufficient knowledge about its concepts and causes and it is grossly insufficient for its practical application in the class room.Conclusions: There is a need to improve the knowledge of primary school teachers on LD and to enhance their basic skills in recognizing learning disability at the earliest. This is very important for the management of these children by introducing and applying the appropriate remedial measures on time. This can go a long way in improving the quality of learning among children with poor scholastic performance.

Spatial Learning and Motor Deficits in Vacuolar Protein Sorting-associated Protein 13b (Vps13b) Mutant Mouse

Vacuolar protein sorting-associated protein 13B (VPS13B), also known as COH1, is one of the VPS13 family members which is involved in transmembrane transport, Golgi integrity, and neuritogenesis. Mutations in the VPS13B gene are associated with Cohen syndrome and other cognitive disorders such as intellectual disabilities and autism spectrum disorder (ASD). However, the patho-physiology of VPS13B-associated cognitive deficits is unclear, in part, due to the lack of animal models. Here, we generated a Vps13b exon 2 deletion mutant mouse and analyzed the behavioral phenotypes. We found that Vps13b mutant mice showed reduced activity in open field test and significantly shorter latency to fall in the rotarod test, suggesting that the mutants have motor deficits. In addition, we found that Vps13b mutant mice showed deficits in spatial learning in the hidden platform version of the Morris water maze. The Vps13b mutant mice were normal in other behaviors such as anxiety-like behaviors, working memory and social behaviors. Our results suggest that Vps13b mutant mice may recapitulate key clinical symptoms in Cohen syndrome such as intellectual disability and hypotonia. Vps13b mutant mice may serve as a useful model to investigate the pathophysiology of VPS13B-associated disorders.

Auditory Middle Latency Response and Phonological Awareness in Students with Learning Disabilities

Introduction Behavioral tests of auditory processing have been applied in schools and highlight the association between phonological awareness abilities and auditory processing, confirming that low performance on phonological awareness tests may be due to low performance on auditory processing tests. Objective To characterize the auditory middle latency response and the phonological awareness tests and to investigate correlations between responses in a group of children with learning disorders. Methods The study included 25 students with learning disabilities. Phonological awareness and auditory middle latency response were tested with electrodes placed on the left and right hemispheres. The correlation between the measurements was performed using the Spearman rank correlation coefficient. Results There is some correlation between the tests, especially between the Pa component and syllabic awareness, where moderate negative correlation is observed. Conclusion In this study, when phonological awareness subtests were performed, specifically phonemic awareness, the students showed a low score for the age group, although for the objective examination, prolonged Pa latency in the contralateral via was observed. Negative weak tomoderate correlation for Pa wave latency was observed, as was positive weak correlation for Na-Pa amplitude.(AU)

An event-related potential study of visual spatial attention span in children with Chinese learning disability / 中华实用儿科临床杂志

Objective To explore whether there is a visual spatial attention span deficit in children with Chi-nese language learning disability and the characteristics of brain electrophysiological dynamic change. Methods Adop-ting event-related potentials ( ERP ) technology and levels of visual spatial attention span with fixed location cuing pa-radigm were used to explore the characteristics of brain electrophysiological dynamic change. Results Based on the behavioral data,the repeated findings of analysis of variance on reaction time showed that both the main effect of the type of subjects[F(1,35)=4. 34,P<0. 05,η2=0. 11],and the main effect of attention span[F(1,35)=138. 75,P<0. 001,η2=0. 79] had statistical significance. The repeated analysis of variance on accuracy showed that the main effect of subjects type[F(1,35)= 4. 99,P<0. 05,η2=0. 13],and the main effect of attention span[F(1,35)=101. 83,P<0. 01,η2=0. 74] were significantly different. Under large and small attention span conditions,the children with Chinese language learning disability showed a longer time of reaction and a lower accuracy rate than the children in the control group. With the electroencephalograph( EEG) data and under large and small attention span conditions,the Chinese learning disability children showed enhanced P1 amplitude and reduced N1 amplitude. Conclusions There is a visual spatial attention span deficit in children with Chinese learning disability which may be caused by a weak prima-ry sensory processing ability and divided attention deficit.

Psychological intervention for specific learning disability: A case report.

Cognitive deficits resulting in poor scholastic performance are common among children with specific learning disabilities. Current study was carried out to identify areas of deficits leading to poor academic performance followed by a home based remediation program for rehabilitation of impaired skills. Single case study method was opted and assessment of academic skills was done using NIMHANS Index for Specific Learning Disability (SLD). Assessment findings revealed significant impairment in scholastic skills and attention processes. Management of identified deficits was planned and weekly sittings of remediation were provided for six months. Monitoring of the rehabilitation package was done on every visit using charting method. Improvement in academic skills/ performance was seen in later sessions.

Seguimiento longitudinal en un caso de retardo en la formación de las funciones psicológicas superiores / Longitudinal study of a child with retardation in psychological superior function

En el artículo se describe el contenido del programa para la corrección y el desarrollo de las funciones psicológicas superiores. Se trata de un niño con problemas en el aprendizaje escolar. Se presentan los resultados de las evaluaciones neuropsicológicas, así como el contenido del programa de corrección. El programa se elaboró de acuerdo a las propuestas del diagnóstico diferencial individualizado. Se muestran las etapas del trabajo correctivo con el niño, así como los resultados de la intervención terapéutica...

The paper describes an individual program for remediation of a learning disable child. The program is based upon an integrated system of Lurian neuropsychological assessment. A follow-up of the child at all steps of remediation proved the efficiency of the remediative program...

Impaired acuity of the approximate number system in 22q11.2 microdeletion syndrome

A magnitude comparison deficit has been frequently observed in velocardiofacial syndrome (Del22q11.2). We hypothesized that this deficit extends to impairments in the acuity of the approximate number system (ANS). Three groups of children aged 8-14 years were investigated: Del22q11.2 children (n = 12), low cognitive ability children (LCA; n = 12), and matched typically developing children (TD; n = 28). All children were assessed with a simple reaction time task and symbolic and nonsymbolic number comparison tasks. To estimate the acuity of the ANS, the Weber fraction (w) was calculated from the nonsymbolic comparison task. The Del22q11.2 group exhibited a significantly higher w compared with the other groups. Importantly, no significant differences were found in w between the TD and LCA groups. The performance pattern of the Del22q11.2 group was similar to the TD group in the symbolic comparison task, and both of these groups had better performance than the LCA group. The impairment of ANS acuity observed in individuals with Del22q11.2 cannot be explained by deficits in general processing speed because no significant group differences were found in the simple reaction time task. These results suggest that lower acuity of the ANS should be added to the behavioral phenotype of Del22q11.2. The absence of impaired ANS acuity in the LCA group is consistent with the hypothesis that number sense is a relatively specific and autonomous domain. Investigations of low ANS acuity in mathematics learning difficulties and Del22q11.2 should be intensified...

Prevalence of specific developmental disorder of scholastic skill in school students in Chandigarh, India.

Background & objectives: Several studies have been conducted in India to determine the prevalence of learning disabilities in school children which has been reported to be 3-10 per cent among students population. The present study was conducted to find out prevalence of specific developmental disorder of scholastic skills in students of classes VII to XII and to find out feasibility of screening tool in Chandigarh, India. Methods: A cross-sectional study on school students was carried out in two phases. The students were drawn from classes VII to XII from 10 schools of Chandigarh, India. Details of academic performance of all the students was taken, subjectively from class teachers and objectively from the marks obtained in the last academic session. In phase I, 2402 students were assessed. In phase II, 108 students were randomly selected for evaluation for assessing sensitivity and specificity of screening proforma for teachers. A total of 124 students from phase I and all students in phase II were assessed in detail. Tests of intelligence (Malin’s Intelligence Scale for Indian Children and Standard Progressive Matrices), and NIMHANS Index for specific learning disability (SLD) battery were administered. Results: A total of 38 students were found to be having specific developmental disorder of scholastic skills in phase I, that gave a prevalence of 1.58 per cent. Majority had mixed type of errors on SLD battery. There were more boys diagnosed with specific learning disability. Teacher’s screening instrument had high sensitivity (90.385) and specificity (94.68). Interpretation & conclusions: The findings of our study conducted in community, showed that specific learning disability was not identified even till later age. The screening instrument thus could be used by teachers to suspect students with specific learning disability.

Impact of allergic rhinitis in school going children

Allergic rhinitis (AR) is the most common chronic pediatric disorder. The International Study for Asthma and Allergies in Childhood phase III found that the global average of current rhinoconjunctivitis symptoms in the 13-14 year age-group was 14.6% and the average prevalence of rhinoconjunctivitis symptoms in the 6-7 year age-group was 8.5%. In addition to classical symptoms, AR is associated with a multidimensional impact on the health related quality of life in children. AR affects the quality of sleep in children and frequently leads to day-time fatigue as well as sleepiness. It is also thought to be a risk factor for sleep disordered breathing. AR results in increased school absenteeism and distraction during class hours. These children are often embarrassed in school and have decreased social interaction which significantly hampers the process of learning and school performance. All these aspects upset the family too. Multiple co-morbidities like sinusitis, asthma, conjunctivitis, eczema, eustachian tube dysfunction and otitis media are generally associated with AR. These mostly remain undiagnosed and untreated adding to the morbidity. To compound the problems, medications have bothersome side effects which cause the children to resist therapy. Children customarily do not complain while parents and health care professionals, more often than not, fail to accord the attention that this not so trivial disease deserves. AR, especially in developing countries, continues to remain a neglected disorder.

Ocular disorders in children with learning disabilities in special education schools of Pune, India.

Aim: The aim was to study and treat ocular disorders in children with learning disabilities (cLDs) and explore associations with their perinatal history. Materials and Methods: cLDs attending 11 special schools were examined by a team consisting of an ophthalmologist, optometrist, and a social worker in 2007 and followed up in 2008. The students‘ intelligence quotient (IQ) and their medical histories were noted. Distant visual acuities were measured using Kay pictures or Snellen's tumbling E chart and complete ocular examination was performed. Students were assessed at the pediatric ophthalmology unit and low vision center, if needed. Statistical analysis was done with SPSS and the Chi-square test for ordinal data. Results: A total of 664 students were examined, 526 of whom were <16 years of age; 323 (61.4%) were male. A total of 326 (60%) had moderate-to-severe learning disabilities (IQs <50), and the mean IQ was 45.4. Two hundred and thirty-eight (45.3%) had ocular disorder; 143 (27.3%) had an uncorrected refractive error, followed by strabismus in 83 (15.8%), nystagmus in 36 (6.8%), optic atrophy in 34 (6.5%), and congenital anomalies in 13 (2.5%), 103 children had more than one abnormality. Only 12 of the 143 students with refractive errors were using spectacles. A total of 132 (48.7%) children with a history of perinatal insult had ocular problems. Ocular disorders were also common in those with a history of epilepsy, Down's syndrome, and cerebral palsy. Conclusion: Nearly half the cLDs in this study had ocular disorders and one-fourth had their vision improved.

Children with Learning Disabilities in the Paediatric Clinic, Hospital Tuanku Ja'afar Seremban: An Overview

The aim of the study was to document the prevalence of learning disability among the children attending the Paediatric Clinic in Hospital Tuanku Ja’afar Seremban. The demographic distribution of these patients; the age of detection of the problem; the associated medical conditions and types of intervention received by these patients were documented. Patients who were between the ages of five to twelve years were included in the study. Learning disability was divided into three categories: speech and articulation problems, academic skills disorder and other categories which included developmental delay. Children with cerebral palsy were excluded from the study. Out of 1320 patients screened, 355 were found to have learning disorders. Majority were Malays, with the male to female ratio of 1.9:1. Most of the patients stayed in Seremban. The learning problem was most commonly detected at the age of 4 years and below. The commonest type of learning disorder was developmental delay, followed by academic skills disorder, speech and academic skills problems and speech disorders. Problems that were detected early were speech problems and developmental delay. Majority of the children had associated medical conditions. Most of the patients received some form of intervention but 11.3% did not attend any intervention program at all. A strategy should be formulated and implemented to help this group of children.

Clinical Diagnosis and Non-Verbal Ability of Primary-One School Children with LD

More school children were referred for learning difficutly (LD), especially after the introduction of LINUS sccreening programme by Ministry of Education Malaysia. To study the clinical diagnosis and non-verbal ability of primary-one school children with LD after paediatric assessment, as well as associated behavioural issues and socio-economincal background. Assessment findings by Paediatricians and Naglieri Non-Verbal Ability Test® (NNAT®) results of all primary-one school children referred in year 2010 with LD were studied retrospectively. Ninety-three children were included (62.4% male), and 72.0% of them failed the LINUS screening programme. The commonest diagnoses were Borderline Intellectual Disability (ID, 37.6%) and Mild ID (19.4%). Other diagnoses included Attention Deficit Hyperactive Disorder (ADHD, 11.8%), Specific Learning Disability (SLD, 10.8%), Autistic Spectrum Disorder (n = 5) and Severe Language Disorder (n = 3). Mean NNAT scores were 84.6 ± 11.8 (n = 85), of which 9.4% children scored less than 70 (<2nd percentile), while 63.7% scored between 71 and 90 (3rd-24th percentile). Twenty-three children(27.1%) scored 90 - 110 (25th-75th percentile) and 111-119 (76th-90th percentile). More than two-thirds of the parents never attended school, or only received education up to Form 3. Nearly 80% of mothers were housewife and 78.7% of fathers were labour or semi-skilled workers. A significant numbers of children with ADHD, Borderline ID, Mild ID and Severe Language Disorder / SLD had significant or borderline internalizing and/or externalizing behaviours.Majority of primary-one school children referred for LD do not have intellectual disability. Their clinical diagnosis and non-verbal ability were very variable. A significant number of them have poor socio-economical background and associated behavioural problems. A more realistic education system and targeted program should be offered.

Comparative Efficacy of Cognitive Retraining Techniques and Remedial Training in Children with Learning Disability.

Background : Computer-assisted cognitive retraining approaches that work on the principle of cerebral plasticity are by now established rehabilitation methods for various neuropsychiatric conditions including Learning Disability. Also, remedial education is considered to be an integral part of management of learning disability. Objectives: To compare the efficacy of cognitive retraining techniques and remedial education for enhancing academic performance of children with learning disability. Sample & Methods: Pre-Post experimental design study was carried out with forty children(between seven to ten years of age), with diagnosis of mixed disorder of scholastic skills (ICD-10). Subjects in Group1 (n=20) were given 36 hours of manualized CR package over 18weeks, consisting of activities for sustained attention, visuospatial skills, visual memory; and verbal learning and memory. Subjects in group 2 (n=20) were given 36-remedial education sessions. Pre and post intervention assessment; was done using NIMHANS Index for Specific Learning Disability, Grade Level Assessment Device(GLAD).SPSS version 12.0 was used for descriptive and analytical statistical analysis. Results: Highly significant improvement was noted in mathematics (p > 0.01) for Group 1. Also, there was significant improvement in Hindi language of Group 2 (p > 0.05). Conclusion: Both-manualized cognitive retraining and remedial education over thirty six hours can help to partially improve scholastic performance in children with learning disability. The findings have implications for combining both the approaches for future educational curricula aiming at improved academic performance stemming from an enhanced skill base rather than from just educational based interventions.