eMedicine Specialties > Pediatrics: Developmental and Behavioral > Medical Topics

Learning Disorder: Mathematics: Follow-up

Author: Vidhu V Thaker, MB, BCh, MD, Instructor in Pediatrics, Albert Einstein College of Medicine; Consulting Staff, Department of Pediatrics, Jacobi Medical Center
Contributor Information and Disclosures

Updated: Dec 17, 2008

Follow-up

Prognosis

Originally approved by the US Congress in 1975, the Individuals with Disabilities Education Act (IDEA) is an attempt to remedy problems that contribute to the barriers faced by children with disabilities.⁵

• IDEA has been updated approximately every 5 years, the latest of which was in 2004. IDEA aims to strengthen academic expectations of, and accountability for, the 5.4 million US children with disabilities and to bridge the too common gap between the regular school curriculum and what these children learn.
• Several ideas have become part of the special education vocabulary because of this law, including free appropriate public education (FAPE), individualized education program (IEP), and least restrictive environment (LRE). These concepts have been built into the special education system to insure equal access to education for all students.
• The reauthorization of IDEA 2004 states the following purposes:
  • 1A - To ensure that all children with disabilities have available to them a FAPE that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment, and independent living
  • 1B - To ensure that the rights of children with disabilities and parents of such children are protected
  • 1C - To assist states, localities, educational service agencies, and federal agencies to provide for the education of all children with disabilities
  • 2 - To assist states in the implementation of a statewide, comprehensive, coordinated, multidisciplinary, interagency system of early intervention services for infants and toddlers with disabilities and their families
  • 3 - To ensure that educators and parents have the necessary tools to improve educational results for children with disabilities by supporting system improvement activities; coordinated research and personnel preparation; coordinated technical assistance, dissemination, and support; and technology development and media services
  • 4 - To assess and ensure the effectiveness of efforts to educate children with disabilities.
• With passage of the IDEA amendments, the US government acknowledged that "Disability is a natural part of the human experience and in no way diminishes the right of individuals to participate in or contribute to society. Improving educational results for children with disabilities is an essential element of our national policy of ensuring equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with disabilities." IDEA strives to increase the involvement of parents and educators in the care of children with disabilities.
• For years, schools were required to wait until a child fell considerably behind grade level before being eligible for special education services. Today, with the release of the final regulations of IDEA 2004, school districts are no longer required to follow this "discrepancy model" but are allowed to find other ways to determine when a child needs extra help. This is being implemented throughout the country through a process called Response to Intervention.
• Prior to the implementation of IDEA in 1975, approximately 1 million children with disabilities were shut out of schools and hundreds of thousands more were denied appropriate services. Since then, IDEA has changed the lives of children with disabilities.
  • Many children now learn and achieve at levels previously thought impossible. As a result, and in unprecedented numbers, these children are graduating from high school, going to college, and entering the workforce as productive citizens.
  • In the past, as many as 90% of children with serious developmental disabilities were housed in state institutions. Today, 3 times as many young people with disabilities are enrolled in colleges or universities; twice as many 20-year-olds with disabilities are working.
• Although significant progress has occurred, the status of children with disabilities still falls short of expectations. The following facts reflect this status:
  • Twice as many children with disabilities drop out of school, compared with children without disabilities.
  • Dropouts do not return to school, have difficulty finding jobs, and often end up in the criminal justice system.
  • Girls who drop out often become young unwed mothers at a much higher rate than their peers without disabilities.
  • Many children with disabilities are excluded from the curriculum and from assessments used with classmates without disabilities, actions that limit their possibilities of excelling and achieving higher standards of performance.

Patient Education

• The following nonprofit organizations provide information, referrals to professionals, and contacts to local groups:
  • Learning Disabilities Association of America (LDA)
    (888) 300-6710
    eMail: Learning Disabilities Association of America
  • National Center for Learning Disabilities (NCLD)
    (888) 575-7573
    (212) 545-7510
  • International Dyslexia Association (IDA)
    (800) ABC-D123
    (410) 296-0232
    eMail: International Dyslexia Association
  • Schwab Foundation for Learning
    (800) 230-0988
    eMail: webmaster@schwablearning.org
  • Council for Exceptional Children (CEC),
    Division for Learning Disabilities (DLD)
    (800) 328-0272
  • IDEA 2004
  • Council for Learning Disabilities (CLD)
    PO Box 40303
    Overland Park, KS 66204
    (913) 492-2546
  • LD Online

Miscellaneous

Medicolegal Pitfalls

• Failure to educate and provide awareness of IDEA and its provisions has implications similar to that of depriving a patient of appropriate medical or surgical therapy.
• Failure to refer a suspected case of learning disability to appropriate agencies for evaluation and then appropriate placement in an individualized education program (IEP), considered the therapy for disabilities, may constitute malpractice.

Special Concerns

• Many students who underachieve in mathematics perceive the subject as hostile and perpetually threatening. Because parents and teachers seriously value mathematics performance, students who underachieve in mathematics must not develop an adversarial relationship with the subject. To prevent such intimidation, students should not be publicly humiliated for their performance.
  • Students with mathematical learning disorder (MD) should not be required to answer questions in class.
  • Teachers must not have other students correct, or even see, papers of students with mathematical learning disorder.
• At home, parents must be aware of the profound feelings of sadness that can overcome a child who is having trouble learning mathematics. Parents must be supportive and as nonjudgmental as possible.
  • Teachers and parents should collaborate to make mathematics fun whenever possible. The use of games and rewards sometimes may facilitate this effort.
  • All children with mathematics difficulties require demystification. They should understand the reasons for mathematical learning disorder. The strengths of these students should be supported. They should be told that mathematics is but 1 of many forms of intelligence and reassured that they are competent individuals.
  • At the same time, students with mathematical learning disorder must sustain a degree of optimism toward the subject, while perceiving mathematics as a challenge. Encourage students to foresee a reasonable level of proficiency as an attainable goal.

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