Massarat Khan – Specific Learning Disorders (SLD)

In this film, expert Massarat Khan offers clarity and insight on the difference between learning disabilities and specific learning disorders. With a focus on early identification, she highlights key warning signs, the importance of timely intervention, and the risks of missing the window for support.
Drawing on her vast experience, she outlines effective strategies and emphasizes the crucial role parents and educators play in transforming lives of students and persons living with specific learning disorders.
*
What is the difference between specific learning disabilities and specific learning disorders?
Earlier the term used was Learning Disability for you know what is now called Specific Learning Disability.
So, under learning disability we had dyslexia, dysgraphia and dyscalculia.
However, uh over a period of time learning disability term was also used for
uh those with low intelligence, struggling with learning,
and you know those maybe with brain damage or some other medical factors who are struggling with learning.
So it became uh you know general terminology.
So everybody who struggle with learning was you know, was said to have a learning disability.
Specific Learning Disability term came in to specify that there is no uh medical factor involved,
there is no brain injury involved,
there are no other uh factors, physical factors that are coming in the way of learning.
So, it’s purely neurologically based and it’s a uh problem with the functioning of the brain
and its affects reading, spelling, writing or mathematics.
So, if its uh affects reading then it is dys—dyslexia, okay; writing dysgraphia; uh maths uh dyscalculia, okay.
Then in 2013 you had DSM-5 coming in, 5th edition,
that is Diagnostic and Statistical Manual of uh Mental Disorders.
And in that the term uh used was Specific Learning Disorders.
So got away with disability, they said it’s not a disability it’s a disorder, it’s a condition.
And they also got away with the terms, dyslexia, dysgraphia, dyscalculia.
So in DSM-5 it uh uh it talks about uh impairment in reading.
Okay, so Specific Learning Disorder with impairment in reading,
Specific Learning Disorder with impairment in written expression,
and Specific Learning Disorder with impairment in mathematical calculation.
Okay which is actually you know def—defining dyslexia, dysgraphia, dyscalculia.
Now the thing is earlier dysgraphia and even today,
uh you know specially where uh you know governmental hospitals are concerned
and even where RPwD act is concerned,
uh dysgraphia refers to both written expression as well as handwriting difficulties.
So, if you a illegi—if you have illegible handwriting, that also you know is diagnosed as dysgraphia.
But as per DSM-5, it’s only written expression now,
uh which comes under Specific Learning Disorder.
So the motor coordination part of it is now a separate category called Developmental Coordination Disorder.
So, your handwriting motor issues come under that.
So uh if you get students uh who are struggling with you know uh handwriting issues, illegible handwriting
due to which they are not able to you know do well in their exams because teachers cannot read their paper,
they get a diagnosis of Developmental Coordination Disorder.
And they get you know so irrespective of whether you call it dysgraphia or developmental coordination disorder,
they get extra time, they get a scribe or you know depending on the board
they get a a laptop or a computer to work on.
*
At what age can dyslexia be identified, and what are its key characteristics?
As early as 4 years of age, you would know whether or not a child is at risk for uh dyslexia.
And so the identification can happen as early as that
and you can start immediately with intervention.
Alright, you don’t need to wait for a formal diagnosis or a label to provide any kind of intervention or support or accommodations.
Uh the early signs would be uh for anybody you know uh we what we would call as warning signs
that uh there is a possibility of the child struggling later on with acade uh academics, would be like, something would be like you know uh missing a milestone also
like crawling, okay or late speech, alright.
And then uh uh getting distracted easily, not being able to focus,
not interested in books or interested only in pictures in the books and not you know the print in the book.
Cannot sit for long time listening to somebody you know narrating a story.
They would be interested in stories but not you know long stories.
Or reading a book, if you know a parent sits with the book to read, they are not interested in that.
They would say, okay, you read the book, you tell me the story.
Also, you will find them struggling with uh uh recitation of the alphabet.
When you introduce the alphabet, they just don’t get the sequence.
So sequencing is a major issue, anything that involves sequencing is a problem.
So you will see them struggling with the one two three fours also.
Later on, you will find that they are able to recite up to 9 and then you have to provide 10, they will go on.
Then they will be stuck at 19, you have to provide 20, they will go on and so forth.
So you will see this you know, anything that requires sequencing is a problem.
As you move into the higher classes, they will have problems with uh
you know uh definitions, with uh formulas, with equations.
Anything that requires memorization.
So rote memorization is another issue.
They will be, they will be happy to explain and give examples,
but the minute you insist that you know they have to rote memorize something and reproduce it as it is verbatim,
you will start seeing the struggle over there.
So, you will see these characteristics as they move ahead in the higher classes too.
So phonological awareness is another area, you know, they—
Because when you talk about dyslexia, it is a deficit in the phonological component of language.
So, they are not able to differentiate between the sounds.
They don’t get the sounds uh of the letters,
and so you will see the struggle over there.
And uh they will not be able to you know, you will see that they struggle with giving rhyming words.
They will struggle uh with being able to differentiate between you know the uh beginning sounds of the words,
or the vowel sounds of the words or the ending sound of the words.
So, for example, like you know if you say ‘bat’ and ‘mat,’ for them ‘bat’ and ‘mat’ both would be same, okay.
If you say you know ‘cut’ and ‘gut,’ for them ‘cut’ and ‘gut’ both would be the same
because the beginning sound ‘k’ and ‘g’ sound the same to them, right.
So you will, so you will see problem with the phonological processing.
And uh because of this, in the higher classes, reading is affected, spelling is affected.
Because everything is to do with sound symbol, so they are not able to make the connection between the sound symbol.
*
Why is early intervention crucial?
Early, early uh you know identification will lead to early intervention.
So early identification becomes very important, only then we’ll have early intervention.
And why early intervention? Because the brain is still in the developing process, right.
Uh till the age of 4, maximum development of the brain takes place.
It’s not that after 4 brain development does not take place,
we all know about neuroplasticity, brain plasticity.
Brain can keep you know developing, growing uh as long as we are alive,
but those are the crucial years.
So if you identify before the age of 4 and give the intervention, you will see maximum progress.
And you will see you know uh less of struggle in in the children.
*
What challenges may arise if early intervention is missed?
So if you, if you miss out on those early stages of intervention,
you will see the children you know struggling with uh reading, with spelling.
They are not able to keep pace with what is happening in the class, they uh you know they’re lagging behind, leading to low self-esteem, low self-confidence.
Uh they develop you know psychological, emotional uh you know conditions.
Uh they, they are uh what you will see is you know withdrawal in some children,
some children will always be quiet uh they will be like recluse, they don’t socialize.
Some, and in some you will see the other way around,
very talkative, distracted, disturb—they come across as you know
deliberately doing things to distract and disturb the others in the class.
You will find them uh indulging in attention seeking behavior or you know uh they will be there as class clowns, always up to some antic or the other, making everybody laugh.
Some of them you know are the favorites of their peers because they love to be in the company.
And some of them can resort to antisocial behavior.
So you would see that you know resulting in delinquency, avoiding, resulting in fights,
verbal abuse, anger issues, lead—which are arising from frustration at not being able to perform.
So uh just one uh you know uh one uh difficulty or disorder can lead to,
can affect a child’s you know overall personality depending on you know the environment,
depending on the support, depending on the understanding the child receives.
So we have seen that when you earl—identify early
and give them the right kind of help and support,
children uh get that sense of you know, there are people who understand me, who are there to help and support me.
So a lot of these psychological, emotional factors are taken care of.
Otherwise, they carry the emotional baggage with them throughout life.
So we had have so many adults who talk about you know them still uh struggling with their emotions,
how badly they have been you know psychologically damaged,
the trauma they have gone through,
the hatred towards school, their teachers.
They don’t, they just don’t want to listen to the name school or teachers.
So this is what they carry with them throughout life,
and we would not want this happening you know.
*
What role do parents play in the early intervention process?
With parents what we, we cannot actually say that you know parents should know about it,
how would the parents know, right, when teachers themselves don’t know.
So though we are creating awareness, a lot is being done,
uh still there is a lot to be done in terms of awareness amongst the teachers.
Now parents will only come to know about it once the teachers report to them.
No parent is going to think about dyslexia or a specific learning disorder or disability and look out for those signs.
How would they do that? They would not know that unless you know somebody points it out to them.
But once you know they come to know about it,
once the teachers or somebody who knows about dyslexia or SLD talks to them about it, then parents need to take that seriously.
What we see is that there is a lot of denial, you know.
They don’t want to accept; they are like there is nothing wrong with my child.
And we cannot blame them because actually there is nothing wrong with the child, right.
The child is just, their child it is just like any other child.
The child does not have a physical disability, does not have any you know
uh in uh uh is not lacking in intelligence because the child is verbose
or is active or has certain you know talents in certain fields.
The only area the child is struggling is with academics.
So the parents and even the teachers, you know.
Uh it’s very easy for them to uh say that the child is not interested.
The child is more interested in, you know, extracurricular activities or in sports or in drama.
They find various reasons for the child’s non-performance, academic non-performance.
And if the parents, okay, who have been uh you know warned or who have been advised that there could be a possibility of SLD uh because of which your child is not performing
and not because your child is involved in other activities,
it would be uh of a great service to their, to their own child.
Because parents don’t realize that by denying
that their child could have a you know some kind of disorder,
they are delaying the intervention process and the more you delay the intervention process,
we talk in terms of you know multiplication.
So the problems multiply.
It’s like you know with every passing year there is a multiplication happening.
And then when you finally accept that your child has a you know disorder that needs to be attended to,
uh it uh I would not say it is too late because it is never too late but the whole process of you know
remediating becomes very strenuous for everybody.
There is a lot of unlearning that has to take place
because whatever the child has learned or
the methodology through which the child has learned was not right for the child.
That is why the child has continued struggling.
So now the child has to first go through the process of unlearning everything,
then you have to start re-learning, you have to start at the base.
So the number of years that would be involved in remediation would you know be three-fold, four-fold.
Whereas with early intervention you will start seeing results you know, even some,
we have seen results within one month also if the parents are focused and involved in the remediation process.
*
What interventions are most effective in supporting children with specific learning disorders?
The best intervention uh research based intervention is through the Orton-Gillingham methodology.
So there are various programs and you know now you can just surf on the net and you will come to know.
So uh this methodology talks about multisensory and it is uh it talks about you know being highly structured.
So whether you have a child coming to you at the age of 4
or you have an adult coming to you at the age of 23 or 40 or 60, it does not matter.
The point of, you know, beginning the remediation is the same.
So the program remains the same, the pace at which you move will change depending on the age
and depending on the severity of the difficulty.
Main focus is on phonological awareness skills.
So by definition as I mentioned earlier, dys—dyslexia is uh due to deficit in the phonological component of language
and so we have to develop the phonological skills.
It is due to the deficit that they are not able to get the sounds and they are not able to connect the sounds with the symbols.
So we dev uh begin with phonological awareness activities.
So phonological awareness activities would involve developing listening skills,
uh listening to the sounds in a sequence.
Listening to sounds, basically it starts with listening to sounds in your environment.
Then listening to specific sounds, like you could you know make sounds of musical instruments
and they need to identify and tell the sequence in which they heard the sounds.
It could be sounds of vehicles, uh animals and so on.
Then we’ll go through to rhyming words because again the without phonological awareness skills, rhyming is a problem.
So you will find children struggling uh in the kindergarten you know with uh rhyming words.
Like if you say ‘bat’ and you ask for a rhyming word, they can tell you, you know ‘pot’ or you know uh ‘but’
or anything ‘bun’ anything, but you know a word rhyming with ‘bat’.
They are not able to identify the sounds, discriminate between the sounds and so they are not able to give you rhyming words.
So working on developing you know rhyming skills.
Then uh segmenting and blending of words,
so for example, and if you know later on sounds.
So for example if I say ‘popcorn’ and I ask you, you know now say pop uh ‘popcorn’ without ‘pop,’
so you should be able to say ‘corn.’
If I say ‘football’ and I say ‘football’ without ‘ball,’ so you should be able to say ‘foot’ and vice versa.
So they are not able to do that.
So lot of exercises, uh these kinds of exercises, then later on it would be with the sounds.
So you know if I say the word ‘bat,’ what’s the beginning sound of ‘bat’?
They should be able to say ‘b.’
What is the ending? ‘t.’
What is the middle sound? ‘a.’
Now if I say, say ‘bat’ again but change the sound of from ‘b’ to ‘m’
and they should you know from ‘b’ to ‘m’
and they should be able to tell you ‘mat.’
And if I say okay now change the sound in ‘mat’ from ‘a’ to ‘i’
and they should be able to tell you ‘mit’ and so on.
So, a lot of these exercises need to be done with the students to be ready to then introduce the sound letter connections.