When learning is tough

Lim Tien Ling, a 36-year-old teacher, noticed that her five-year-old son Luke had a tendency to use excessive force while at play, or when he hugged people. When he was three, he had a particularly heightened sense of smell, and was a 'late talker'. Even with her training and experience as a teacher, she didn't have a clue why he was like that, or what to do about it.

In the end, she decided to get professional help to have him assessed. As it turned out, Luke had sensory integration disorder - a learning disability (or learning disorder).

Ms Lim is among the growing number of parents with similar 'problem' kids who are now turning to psychologists and occupational therapists rather than just hoping their kids are only in a phase that they will grow out of.

'There is definitely more openness in seeking professional help these days,' says Shelwyn Tay, clinical psychologist at the Centre for Effective Living, a psychology-based firm offering professional counselling.

Another practice, Ozworks Therapy, doubled the number of therapists at its centre since setting up practice in 2002. But one of its founders, Jaclyn Tan, is careful to explain that this is not necessarily an indication that more children are developing a learning disability. 'I think parents are more aware of services that can help their children cope with school and daily life.'

Ms Tay agrees, explaining that the increasing number of cases has 'more to do with awareness and expectations than a real increase caused by genetic or environmental factors'.

In a place like Singapore where the academic environment is so competitive - the establishment of centres like Centre for Effective Living and Ozworks Therapy is good news. Especially when they provide answers to poor academic performance.

However, young parents should not confuse a learning disability with a lack of intelligence. It isn't. A learning disability is a result of underlying development problems like sensory processing difficulties, lack of visual scanning abilities, slow motor-coordination or motor-planning.

Dyspraxia (difficulty with fine motor skills), dyslexia (difficulty processing language) and sensory integration disorder (difficulty processing multiple sensory inputs) are all examples of a learning disability. (According to the Dyslexia Association of Singapore, the incidence of dyslexia in Singapore is within the international range of 3 per cent to 10 per cent of the population. There are about 20,000 primary and secondary school students who are dyslexic - an average of one to two students in a class of 40.)

Warning signs

Warning signs

Early warning signs of a learning disorder often include delayed speech, difficulty with reading or writing, poor visual-motor coordination or inability to stay focused.

Diagnosing a learning disorder can be complicated though. 'A typical assessment process involves interviewing parents to get an idea of developmental history and background to the problem,' says Ms Tay. An IQ test is done, followed by other tests to assess specific skills. 'A distinction is made between general learning disability, like mental retardation or intellectual disability, and specific learning disabilities, such as dyslexia or attention deficit disorder,' she adds.

For school-age children, behaviour management strategies are then designed accordingly. Alternatively, they could be referred to occupational therapists or education specialists.

OzWork's Ms Tan explains that occupational therapists are able to assess the child's motor coordination, visual-perception, handwriting and pre-school skills. Poor academic performance may be caused by problems in these areas. For such cases, Ms Tan says that she uses different therapy methods, from sensory integration and cognitive learning to visual perception training and behaviour management. The duration of the therapy varies with the severity of the disorder, ranging from six months to two or three years.

It is not uncommon for some talented children (some with IQ test scores above 140) to display a wide discrepancy between verbal IQ and performance IQ which suggests a possible learning disorder. These children are not necessarily compromised intellectually - the information has to be presented in a way that they can access it. There is no cure per se for a learning disability, but with the right support and intervention, that child has a fair chance of achieving success in school and later in life.

But when a learning disorder is left unchecked, emotional and social issues may arise, like low self-esteem, withdrawal or even stress and anxiety. Such issues can get to the point that psychiatric help might be necessary, cautions Associate Professor Fung, chief and senior consultant, Child and Adolescent Psychiatry, at the Institute of Mental Health.

Parental expectations

So should parents manage expectations then?

'Competition is quite real in schools today, but parents should not get overly concerned,' assures Associate Professor Fung. 'A child who appears extremely bright at three, but finds school work a challenge by the time he or she is in primary school, may just be levelling out. This is perfectly normal. Some schools tend to give more school work than may be manageable for that kid.'

However, for kids who are diagnosed with a learning disability, Ms Tan says: 'We try to help parents understand their child's behaviour and advise them on how to manage it.'

Today, Ms Lim is a stay-at-home mother who ensures Luke attends his weekly occupational therapy session. Since he was diagnosed and enrolled in therapy, she has noticed significant improvement in his behaviour, she says. You would not be able to tell him apart from a child in a mainstream school, she adds.

According to Ms Tay, parents play a big part in how well the child copes subsequently. She asserts: 'Parents who understand their child's learning needs are more successful at coming up with strategies that work, tend to be more patient and are also better able to communicate with others when their child needs additional help.'


This article was first published in The Business Times.