Learning Disabilities

(see also Web sites below & our Devel. Disability page for local  school rights)

Reprinted courtesy of:

National Institutes of Health
     National Institute of Mental Health

    Imagine having important needs and ideas to communicate, but being unable
to express them. Perhaps feeling bombarded by sights and sounds, unable to
focus your attention. Or trying to read or add but not being able to make
sense of the letters or numbers.                   
     You may not need to imagine. You may be the parent or teacher of a
child experiencing academic problems, or have someone in your family
diagnosed as learning disabled. Or possibly as a child you were told you
had a reading problem called dyslexia or some other learning handicap.                  
     Although different from person to person, these difficulties make up
the common daily experiences of many learning disabled children,
adolescents, and adults. A person with a learning disability may experience
a cycle of academic failure and lowered self-esteem. Having these
handicaps--or living with someone who has them--can bring overwhelming
     But the prospects are hopeful. It is important to remember that a
person with a learning disability can learn. The disability usually only
affects certain limited areas of a child's development. In fact, rarely are
learning disabilities severe enough to impair a person's potential to live
a happy, normal life.                  
     This booklet is provided by the National Institute of Mental Health
(NIMH), the Federal agency that supports research nationwide on the brain,
mental illnesses, and mental health. Scientists supported by NIMH are
dedicated to understanding the workings and interrelationships of the
various regions of the brain, and to finding preventions and treatments to
overcome brain dysfunctions that handicap people in school, work, and play.                  
     The booklet provides up--to-date information on learning disabilities
and the role of NIMH-sponsored research in discovering underlying causes
and effective treatments. It describes treatment options, strategies for
coping, and sources of information and support. Among these sources are
doctors, special education teachers, and mental health professionals who
can help identify learning disabilities and recommend the right combination
of medical, psychosocial, and educational treatment.                  
     In this booklet, you'll also read the stories of Susan, Wallace, and
Dennis, three people who have learning disabilities. Although each had a
rough start, with help they learned to cope with their handicaps. You'll
see their early frustrations, their steps toward getting help, and their
hopes for the future.                  
     The stories of Susan, Wallace, and Dennis are representative of people
with learning disabilities, but the characters are not real. Of course,
people with learning disabilities are not all alike, so these stories may
not fit any particular individual.                  
At age 14, Susan still tends to be quiet. Ever since she was a child, she
was so withdrawn that people sometimes forgot she was there. She seemed to
drift into a world of her own. When she did talk, she often called objects
by the wrong names. She had few friends and mostly played with dolls or her
little sister. In school, Susan hated reading and math because none of the
letters, numbers or "+" and "-" signs made any sense. She felt awful about
herself. She'd been told--and was convinced--that she was retarded.                  
Wallace has lived 46 years, and still has trouble understanding what people
say. Even as a boy, many words sounded alike. His father patiently said
things over and over. But whenever his mother was drunk, she flew into a
rage and spanked him for not listening. Wallace's speech also came out
funny. He had such problems saying words that in school his teacher
sometimes couldn't understand him. When classmates called him a "dummy,"
his fists just seemed to take over.                  
Dennis is 23 years old and still seems to have too much energy. But he had
always been an overactive boy, sometimes jumping on the sofa for hours
until he collapsed with exhaustion. In grade school, he never sat still. He
interrupted lessons. But he was a friendly, well-meaning kid, so adults
didn't get too angry. His academic problems became evident in third grade,
when his teacher realized that Dennis could only recognize a few words and
wrote like a first grader. She recommended that Dennis repeat third grade,
to give him time to "catch up." After another full year, his behavior was
still out of control, and his reading and writing had not improved.                  
What Is a Learning Disability?                  
Unlike other disabilities, such as paralysis or blindness, a learning
disability (LD) is a hidden handicap. A learning disability doesn't
disfigure or leave visible signs that would invite others to be
understanding or offer support. A woman once blurted to Wallace, "You seem
so intelligent--you don't look handicapped!"                  
     LD is a disorder that affects people's ability to either interpret
what they see and hear or to link information from different parts of the
brain. These limitations can show up in many ways--as specific difficulties
with spoken and written language, coordination, self-control, or attention.
Such difficulties extend to schoolwork and can impede learning to read or
write, or to do math.                  
     Learning disabilities can be lifelong conditions that, in some cases,
affect many parts of a person's life: school or work, daily routines,
family life, and sometimes even friendships and lay. In some people, many
overlapping learning disabilities may be apparent. Other people may have a
single, isolated learning problem that has little impact on other areas of
their lives.                  
What Are the Types of Learning Disabilities?                  
"Learning disability" is not a diagnosis in the same sense as "chickenpox"
or "mumps." Chickenpox and mumps imply a single, known cause with a
predictable set of symptoms. Rather, LD is a broad term that covers a pool
of possible causes, symptoms, treatments, and outcomes. Partly because
learning disabilities can show up in so many forms, it is difficult to
diagnose or to pinpoint the causes. And no one knows of a pill or remedy
that will cure them.                  
     Not all learning problems are necessarily learning disabilities. Many
children are simply slower in developing certain skills. Because children
show natural differences in their rate of development, sometimes what seems
to be a learning disability may simply be a delay in maturation. To be
diagnosed as a learning disability, specific criteria must be met.                  
     The criteria and characteristics for diagnosing learning disabilities
appear in a reference book called the DSM (short for the Diagnostic and
Statistical Manual of Mental Disorders). The DSM diagnosis is commonly used
when applying for health insurance coverage of diagnostic and treatment
     Learning disabilities can be divided into three broad categories:
        o Developmental speech and language disorders
        o Academic skills disorders
        o "Other," a catch-all that includes certain coordination disorders
          and learning handicaps not covered by the other terms                  
     Each of these categories includes a number of more specific disorders.                  
Developmental Speech and Language Disorders                  
Speech and language problems are often the earliest indicators of a
learning disability. People with developmental speech and language
disorders have difficulty producing speech sounds, using spoken language to
communicate, or understanding what other people say. Depending on the
problem, the specific diagnosis may be:                  
   o Developmental articulation disorder
   o Developmental expressive language disorder
   o Developmental receptive language disorder                  
     Developmental Articulation Disorder -- Children with this disorder may
have trouble controlling their rate of speech. Or they may lag behind
playmates in learning to make speech sounds. For example, Wallace at age 6
still said "wabbit" instead of "rabbit" and "thwim" for "swim."
Developmental articulation disorders are common. They appear in at least 10
percent of children younger than age 8. Fortunately, articulation disorders
can often be outgrown or successfully treated with speech therapy.                  
     Developmental Expressive Language Disorder -- Some children with
language impairments have problems expressing themselves in speech. Their
disorder is called, therefore, a developmental expressive language
disorder. Susan, who often calls objects by the wrong names, has an
expressive language disorder. Of course, an expressive language disorder
can take other forms. A 4-year-old who speaks only in two-word phrases and
a 6-year-old who can't answer simple questions also have an expressive
language disability.                  
     Developmental Receptive Language Disorder -- Some people have trouble
understanding certain aspects of speech. It's as if their brains are set to
a different frequency and the reception is poor. There's the toddler who
doesn't respond to his name, a preschooler who hands you a bell when you
asked for a ball, or the worker who consistently can't follow simple
directions. Their hearing is fine, but they can't make sense of certain
sounds, words, or sentences they hear. They may even seem inattentive.
These people have a receptive language disorder. Because using and
understanding speech are strongly related, many people with receptive
language disorders also have an expressive language disability.                  
     Of course, in preschoolers, some misuse of sounds, words, or grammar
is a normal part of learning to speak. It's only when these problems
persist that there is any cause for concern.                  
Academic Skills Disorders                  
Students with academic skills disorders are often years behind their
classmates in developing reading, writing, or arithmetic skills. The
diagnoses in this category include:                  
   o Developmental reading disorder
   o Developmental writing disorder
   o Developmental arithmetic disorder                  
     Developmental Reading Disorder -- This type of disorder, also known as
dyslexia, is quite widespread. In fact, reading disabilities affect 2 to 8
percent of elementary school children.                  
     When you think of what is involved in the "three R's"--reading,
'riting, and 'rithmetic--it's astounding that most of us do learn them.
Consider that to read, you must simultaneously:                  
   o Focus attention on the printed marks and control eye movements across
     the page
   o Recognize the sounds associated with letters
   o Understand words and grammar
   o Build ideas and images
   o Compare new ideas to what you already know
   o Store ideas in memory                  
     Such mental juggling requires a rich, intact network of nerve cells
that connect the brain's centers of vision, language, and memory.                  
     A person can have problems in any of the tasks involved in reading.
However, scientists found that a significant number of people with dyslexia
share an inability to distinguish or separate the sounds in spoken words.
Dennis, for example, can't identify the word "bat" by sounding out the
individual letters, b-a-t. Other children with dyslexia may have trouble
with rhyming games, such as rhyming "cat" with "bat." Yet scientists have
found these skills fundamental to learning to read. Fortunately, remedial
reading specialists have developed techniques that can help many children
with dyslexia acquire these skills.                  
     However, there is more to reading than recognizing words. If the brain
is unable to form images or relate new ideas to those stored in memory, the
reader can't understand or remember the new concepts. So other types of
reading disabilities can appear in the upper grades when the focus of
reading shifts from word identification to comprehension.                  
     Developmental Writing Disorder -- Writing, too, involves several brain
areas and functions. The brain networks for vocabulary, grammar, hand
movement, and memory must all be in good working order. So a developmental
writing disorder may result from problems in any of these areas. For
example, Dennis, who was unable to distinguish the sequence of sounds in a
word, had problems with spelling. A child with a writing disability,
particularly an expressive language disorder, might be unable to compose
complete, grammatical sentences.                  
     Developmental Arithmetic Disorder -- If you doubt that arithmetic is a
complex process, think of the steps you take to solve this simple problem:
25 divided by 3 equals ?                  
     Arithmetic involves recognizing numbers and symbols, memorizing facts
such as the multiplication table, aligning numbers, and understanding
abstract concepts like place value and fractions. Any of these may be
difficult for children with developmental arithmetic disorders. Problems
with numbers or basic concepts are likely to show up early. Disabilities
that appear in the later grades are more often tied to problems in
     Many aspects of speaking, listening, reading, writing, and arithmetic
overlap and build on the same brain capabilities. So it's not surprising
that people can be diagnosed as having more than one area of learning
disability. For example, the ability to understand language underlies
learning speak. Therefore, any disorder that hinders the ability to
understand language will also interfere with the development of speech,
which in turn hinders learning to read and write. A single gap in the
brain's operation can disrupt many types of activity.                  
"Other" Learning Disabilities                  
The DSM also lists additional categories, such as "motor skills disorders"
and "specific developmental disorders not otherwise specified." These
diagnoses include delays in acquiring language, academic, and motor skills
that can affect the ability to learn, but do not meet the criteria for a
specific learning disability. Also included are coordination disorders that
can lead to poor penmanship, as well as certain spelling and memory
Attention Disorders                  
Nearly 4 million school-age children have learning disabilities. Of these,
at least 20 percent have a type of disorder that leaves them unable to
focus their attention.                  
     Some children and adults who have attention disorders appear to
daydream excessively. And once you get their attention, they're often
easily distracted. Susan, for example, tends to mentally drift off into a
world of her own. Children like Susan may have a number of learning
difficulties. If, like Susan, they are quiet and don't cause problems,
their problems may go unnoticed. They may be passed along from grade to
grade, without getting the special assistance they need.                  
     In a large proportion of affected children--mostly boys--the attention
deficit is accompanied by hyperactivity. Dennis is an example of a person
with attention deficit hyperactivity disorder--ADHD. They act impulsively,
running into traffic or toppling desks. Like young Dennis, who jumped on
the sofa to exhaustion, hyperactive children can't sit still. They blurt
out answers and interrupt. In games, they can't wait their turn. These
children's problems are usually hard to miss. Because of their constant
motion and explosive energy, hyperactive children often get into trouble
with parents, teachers, and peers.                  
     By adolescence, physical hyperactivity usually subsides into fidgeting
and restlessness. But the problems with attention and concentration often
continue into adulthood. At work, adults with ADHD often have trouble
organizing tasks or completing their work. They don't seem to listen to or
follow directions. Their work may be messy and appear careless.                  
     Attention disorders, with or without hyperactivity, are not considered
learning disabilities in themselves. However, because attention problems
can seriously interfere with school performance, they often accompany
academic skills disorders.                  
What Causes Learning Disabilities                  
Understandably, one of the first questions parents ask when they learn
their child has a learning disorder is "Why? What went wrong?"                  
     Mental health professionals stress that since no one knows what causes
learning disabilities, it doesn't help parents to look backward to search
for possible reasons. There are too many possibilities to pin down the
cause of the disability with certainty. It is far more important for the
family to move forward in finding ways to get the fight help.                  
     Scientists, however, do need to study causes in an effort to identify
ways to prevent learning disabilities.                  
     Once, scientists thought that all learning disabilities were caused by
a single neurological problem. But research supported by NIMH has helped us
see that the causes are more diverse and complex. New evidence seems to
show that most learning disabilities do not stem from a single, specific
area of the brain, but from difficulties in bringing together information
from various brain regions.                  
     Today, a leading theory is that learning disabilities stem from subtle
disturbances in brain structures and functions. Some scientists believe
that, in many cases, the disturbance begins before birth.                  
Errors in Fetal Brain Development                  
Throughout pregnancy, the fetal brain develops from a few all-purpose cells
into a complex organ made of billions of specialized, interconnected nerve
cells called neurons. During this amazing evolution, things can go wrong
that may alter how the neurons form or interconnect.                  
     In the early stages of pregnancy, the brain stem forms. It controls
basic life functions such as breathing and digestion. Later, a deep ridge
divides the cerebrum--the thinking part of the brain--into two halves, a
right and left hemisphere. Finally, the areas involved with processing
sight, sound, and other senses develop, as well as the areas associated
with attention, thinking, and emotion.                  
     As new cells form, they move into place to create various brain
structures. Nerve cells rapidly grow to form networks with other parts of
the brain. These networks are what allow information to be shared among
various regions of the brain.                  
     Throughout pregnancy, this brain development is vulnerable to
disruptions. If the disruption occurs early, the fetus may die, or the
infant may be born with widespread disabilities and possibly mental
retardation. If the disruption occurs later, when the cells are becoming
specialized and moving into place, it may leave errors in the cell makeup,
location, or connections. Some scientists believe that these errors may
later show up as learning disorders.                  
     (Graphic Omitted. Shows brain development for stages 4-, 6-, and
8-month-old fetus; birth; and adult.)                  
Other Factors That Affect Brain Development                  
Through experiments with animals, scientists at NIMH and other research
facilities are tracking clues to determine what disrupts brain development.
By studying the normal processes of brain development, scientists can
better understand what can go wrong. Some of these studies are examining
how genes, substance abuse, pregnancy problems, and toxins may affect the
developing brain.                  
     Genetic Factors -- The fact that learning disabilities tend to run in
families indicates that there may be a genetic link. For example, children
who lack some of the skills needed for reading, such as hearing the
separate sounds of words, are likely to have a parent with a related
problem. However, a parent's learning disability may take a slightly
different form in the child. A parent who has a writing disorder may have a
child with an expressive language disorder. For this reason, it seems
unlikely that specific learning disorders are inherited directly. Possibly,
what is inherited is a subtle brain dysfunction that can in turn lead to a
learning disability.                  
     There may be an alternative explanation for why LD might seem to run
in families. Some learning difficulties may actually stem from the family
environment. For example, parents who have expressive language disorders
might talk less to their children, or the language they use may be
distorted. In such cases, the child lacks a good model for acquiring
language and therefore, may seem to be learning disabled.                  
     Tobacco, Alcohol, and Other Drug Use -- Many drugs taken by the mother
pass directly to the fetus. Research shows that a mother's use of
cigarettes, alcohol, or other drugs during pregnancy may have damaging
effects on the unborn child. Therefore, to prevent potential harm to
developing babies, the U.S. Public Health Service supports efforts to make
people aware of the possible dangers of smoking, drinking, and using drugs.                  
     Scientists have found that mothers who smoke during pregnancy may be
more likely to bear smaller babies. This is a concern because small
newborns, usually those weighing less than 5 pounds, tend to be at risk for
a variety of problems, including learning disorders.                  
     Alcohol also may be dangerous to the fetus' developing brain. It
appears that alcohol may distort the developing neurons. Heavy alcohol use
during pregnancy has been linked to fetal alcohol syndrome, a condition
that can lead to low birth weigh, intellectual impairment, hyperactivity,
and certain physical defects. Any alcohol use during pregnancy, however,
may influence the child's development and lead to problems with learning,
attention, memory, or problem solving. Because scientists have not yet
identified "safe" levels, alcohol should be used cautiously by women who
are pregnant or who may soon become pregnant.                  
     Drugs such as cocaine--especially in its smokable form known as
crack--seem to affect the normal development of brain receptors. These
brain cell parts help to transmit incoming signals from our skin, eyes, and
ears, and help regulate our physical response to the environment. Because
children with certain learning disabilities have difficulty understanding
speech sounds or letters, some researchers believe that learning
disabilities, as well as ADHD, may be related to faulty receptors. Current
research points to drug abuse as a possible cause of receptor damage.                  
     Problems During Pregnancy or Delivery -- Other possible causes of
learning disabilities involve complications during pregnancy. In some
cases, the mother's immune system reacts to the ferns and attacks it as if
it were an infection. This type of disruption seems to cause newly formed
brain cells to settle in the wrong part of the brain. Or during delivery,
the umbilical cord may become twisted and temporarily cut off oxygen to the
fetus. This, too, can impair brain functions and lead to LD.                  
     Toxins in the Child's Environment -- New brain cells and neural
networks continue to be produced for a year or so after the child is born.
These cells are vulnerable to certain disruptions, also.                  
     Researchers are looking into environmental toxins that may lead to
learning disabilities, possibly by disrupting childhood brain development
or brain processes. Cadmium and lead, both prevalent in the environment,
are becoming a leading focus of neurological research. Cadmium, used in
making some steel products, can get into the soil, then into the foods we
eat. Lead was once common in paint and gasoline, and is still present in
some water pipes. A study of animals sponsored by the National Institutes
of Health showed a connection between exposure to lead and learning
difficulties. In the study, rats exposed to lead experienced changes in
their brainwaves, slowing their ability to learn. The learning problems
lasted for weeks, long after the rats were no longer exposed to lead.                  
     In addition, there is growing evidence that learning problems may
develop in children with cancer who had been treated with chemotherapy or
radiation at an early age. This seems particularly true of children with
brain tumors who received radiation to the skull.                  
Are Learning Disabilities Related to Differences in the Brain?                  
In comparing people with and without learning disabilities, scientists have
observed certain differences in the structure and functioning of the brain.
For example, new research indicates that there may be variations in the
brain structure called the planum temporale, a language-related area found
in both sides of the brain. In people with dyslexia, the two structures
were found to be equal in size. In people who are not dyslexic, however,
the left planum temporale was noticeably larger. Some scientists believe
reading problems may be related to such differences.                  
     With more research, scientists hope to learn precisely how differences
in the structures and processes of the brain contribute to learning
disabilities, and how these differences might be treated or prevented.                  
GETTING HELP                  
>Susan was promoted to the sixth grade but still couldn't do basic math.
So, her mother brought her to a private clinic for testing. The clinician
observed that Susan had trouble associating symbols with their meaning, and
this was holding back her language, reading, and math development. Susan
called objects by the wrong words and she could not associate sounds with
letters or recognize math symbols. However, an IQ of 128 meant that Susan
was quite bright. In addition to developing an Individualized Education
Plan, the clinician recommended that Susan receive counseling for her low
self-esteem and depression.                  
In the early 1960s, at the request of his ninth grade teacher, Wallace was
examined by a doctor to see why he didn't speak or listen well. The doctor
tested his vocal cords, vision, and hearing. They were all fine. The
teacher concluded that Wallace must have "brain damage," so not much could
be done. Wallace kept failing in school and was suspended several times for
fighting. He finally dropped out after tenth grade. He spent the next 25
years working as a janitor. Because LD frequently went undiagnosed at the
time when Wallace was young, the needed help was not available to him.                  
In fifth grade, Dennis' teacher sent him to the school psychologist for
testing. Dennis was diagnosed as having developmental reading and
developmental writing disorders. He was also identified as having an
attention disorder with hyperactivity. He was placed in an all-day special
education program, where he could work on his particular deficits and get
individual attention. His family doctor prescribed the medication Ritalin
to reduce his hyperactivity and distractibility. Along with working to
improve his reading, the special education teacher helped him improve his
listening skills. Since his handwriting was still poor, he learned to type
homework and reports on a computer. At age 19, Dennis graduated from high
school and was accepted by a college that gives special assistance to
students with learning disabilities.                  


How Are Learning Disabilities First Identified?                  
The first step in solving any problem is realizing there is one. Wallace,
sadly, was a product of his time, when learning disabilities were more of a
mystery and often went unrecognized. Today, professionals would know how to
help Wallace. Dennis and Susan were able to get help because someone saw
the problem and referred them for help.                  
     When a baby is born, the parents eagerly wait for the baby's first
step, first word, a myriad of other "firsts." During routine checkups, the
pediatrician, too, watches for more subtle signs of development. The
parents and doctor are watching for the child to achieve developmental
milestones. The developmental milestones chart (omitted here; see page 18
of brochure) lists a few of these markers and the ages and grades that they
typically appear.                  
     Parents are usually the first to notice obvious delays in their child
reaching early milestones. The pediatrician may observe more subtle signs
of minor neurological damage, such as a lack of coordination. But the
classroom teacher, in fact, may be the first to notice the child's
persistent difficulties in reading, writing, or arithmetic. As school tasks
become more complex, a child with a learning disability may have problems
mentally juggling more information.                  
     The learning problems of children who are quiet and polite in school
may go unnoticed. Children with above average intelligence, who manage to
maintain passing grades despite their disability, are even less likely to
be identified. Children with hyperactivity, on the other hand, will be
identified quickly by their impulsive behavior and excessive movement.
Hyperactivity usually begins before age 4 but may not be recognized until
the child enters school.                  
     What should parents, doctors, and teachers do if critical
developmental milestones haven't appeared by the usual age? Sometimes it's
best to allow a little more time, simply for the brain to mature a bit. But
if a milestone is already long delayed, if there's a history of learning
disabilities in the family, or if there are several delayed kills, the
child should be professionally evaluated as soon as possible. An educator
or a doctor who treats children can suggest where to go for help.                  
How Are Learning Disabilities Formally Diagnosed?                  
By law, learning disability is defined as a significant gap between a
person's intelligence and the skills the person has achieved at each age.
This means that a severely retarded 10-year-old who speaks like a
6-year-old probably doesn't have a language or speech disability. He has
mastered language up to the limits of his intelligence. On the other hand,
a fifth grader with an IQ of 100 who can't write a simple sentence probably
does have LD.                  
     Learning disorders may be informally flagged by observing significant
delays in the child's skill development. A 2-year delay in the primary
grades is usually considered significant. For older students, such a delay
is not as debilitating, so learning disabilities aren't usually suspected
unless there is more than a 2-year delay. Actual diagnosis of learning
disabilities, however, is made using standardized tests that compare the
child's level of ability to what is considered normal development for a
person of that age and intelligence.                  
     For example, as late as fifth grade, Susan couldn't add two numbers,
even though she rarely missed school and was good in other subjects. Her
mother took her to a clinician, who observed Susan's behavior and
administered standardized math and intelligence tests. The test results
showed that Susan's math skills were several years behind, given her mental
capacity for learning. Once other possible causes like lack of motivation
and vision problems were ruled out, Susan's math problem was formally
diagnosed as a specific learning disability.                  
     Test outcomes depend not only on the child's actual abilities, but on
the reliability of the test and the child's ability to pay attention and
understand the questions. Children like Dennis, with poor attention or
hyperactivity, may score several points below their true level of ability.
Testing a child in an isolated room can sometimes help the child
concentrate and score higher.                  
     Each type of LD is diagnosed in slightly different ways. To diagnose
speech and language disorders, a speech therapist tests the child's
pronunciation, vocabulary, and grammar and compares them to the
developmental abilities seen in most children that age. A psychologist
tests the child's intelligence. A physician checks for any ear infections,
and an audiologist may be consulted to rule out auditory problems. If the
problem involves articulation, a doctor examines the child's vocal cords
and throat.                  
     In the case of academic skills disorders, academic development in
reading, writing, and math is evaluated using standardized tests. In
addition, vision and hearing are tested to be sure the student can see
words clearly and can hear adequately. The specialist also checks if the
child has missed much school. It's important to rule out these other
possible factors. After all, treatment for a learning disability is very
different from the remedy for poor vision or missing school.                  
     ADHD is diagnosed by checking for the long-term presence of specific
behaviors, such as considerable fidgeting, losing things, interrupting, and
talking excessively. Other signs include an inability to remain seated,
stay on task, or take turns. A diagnosis of ADHD is made only if the child
shows such behaviors substantially more than other children of the same
     If the school fails to notice a learning delay, parents can request an
outside evaluation. In Susan's case, her mother chose to bring Susan to a
clinic for testing. She then brought documentation of the disability back
to the school. After confirming the diagnosis, the public school was
obligated to provide the kind of instructional program that Susan needed.                  
     Parents should stay abreast of each step of the school's evaluation.
Parents also need to know that they may appeal the school's decision if
they disagree with the findings of the diagnostic team. And like Susan's
mother, who brought Susan to a clinic, parents always have the option of
getting a second opinion.                  
     Some parents feel alone and confused when talking to learning
specialists. Such parents may find it helpful to ask someone they like and
trust to go with them to school meetings. The person may be the child's
clinician or caseworker, or even a neighbor. It can help to have someone
along who knows the child and can help understand the child's test scores
or learning problems.                  
What Are the Education Options?                  
Although obtaining a diagnosis is important, even more important is
creating a plan for getting the right help. Because LD can affect the child
and family in so many ways, help may be needed on a variety of fronts:
educational, medical, emotional, and practical.                  
     In most ways, children with learning disabilities are no different
from children without these disabilities. At school, they eat together and
share sports, games, and after-school activities. But since children with
learning disabilities do have specific learning needs, most public schools
provide special programs.                  
     Schools typically provide special education programs either in a
separate all-day classroom or as a special education class that the student
attends for several hours each week. Some parents hire trained tutors to
work with their child after school. If the problems are severe, some
parents choose to place their child in a special school for the learning
     If parents choose to get help outside the public schools, they should
select a learning specialist carefully. The specialist should be able to
explain things in terms that the parents can understand. Whenever possible,
the specialist should have professional certification and experience with
the learner's specific age group and type of disability. Some of the
support groups listed at the end of this booklet can provide references to
qualified special education programs.                  
     Planning a special education program begins with systematically
identifying what the student can and cannot do. The specialist looks for
patterns in the child's gaps. For example, if the child fails to hear the
separate sounds in words, are there other sound discrimination problems? If
there's a problem with handwriting, are there other motor delays? Are there
any consistent problems with memory?                  
     Special education teachers also identify the types of tasks the child
can do and the senses that function well. By using the senses that are
intact and bypassing the disabilities, many children can develop needed
skills. These strengths offer alternative ways the child can learn.                  
     After assessing the child's strengths and weaknesses, the special
education teacher designs an Individualized Educational Program (IEP). The
IEP outlines the specific skills the child needs to develop as well as
appropriate learning activities that build on the child's strengths. Many
effective learning activities engage several skills and senses. For
example, in learning to spell and recognize words, a student may be asked
to see, say, write, and spell each new word. The student may also write the
words in sand, which engages the sense of touch. Many experts believe that
the more senses children use in learning a skill, the more likely they are
to retain it.                  
     An individualized, skill-based approach--like the approach used by
speech and language therapists--often succeeds in helping where regular
classroom instruction fails. Therapy for speech and language disorders
focuses on providing a stimulating but structured environment for heating
and practicing language patterns. For example, the therapist may help a
child who has an articulation disorder to produce specific speech sounds.
During an engaging activity, the therapist may talk about the toys, then
encourage the child to use the same sounds or words. In addition, the child
may watch the therapist make the sound, feel the vibration in the
therapist's throat, then practice making the sounds before a mirror.                  
     Researchers are also investigating nonstandard teaching methods. Some
create artificial learning conditions that may help the brain receive
information in nonstandard ways. For example, in some language disorders,
the brain seems abnormally slow to process verbal information. Scientists
are testing whether computers that talk can help teach children to process
spoken sounds more quickly. The computer starts slowly, pronouncing one
sound at a time. As the child gets better at recognizing the sounds and
heating them as words, the sounds are gradually speeded up to a normal rate
of speech.                  
Is Medication Available?                  
For nearly six decades, many children with attention disorders have
benefited from being treated with medication. Three rugs, Ritalin
(methylphenidate), Dexedrine (dextroamphetamine), and Cylert (pemoline),
have been used successfully. Although these drugs are stimulants in the
same category as "speed" and "diet pills," they seldom make children "high"
or more jittery. Rather, they temporarily improve children's attention and
ability to focus. They also help children control their impulsiveness and
other hyperactive behaviors.                  
     The effects of medication are most dramatic in children with ADHD.
Shortly after taking the medication, they become more able to focus their
attention. They become more ready to learn. Studies by NIMH scientists and
other researchers have shown that at least 90 percent of hyperactive
children can be helped by either Ritalin or Dexedrine. If one medication
does not help a hyperactive child to calm down and pay attention in school,
the other medication might.                  
     The drugs are effective for 3 to 4 hours and move out of the body
within 12 hours. The child's doctor or a psychiatrist works closely with
the family and child to carefully adjust the dosage and medication schedule
for the best effect. Typically, the child takes the medication so that the
drug is active during peak school hours, such as when reading and math are
     In the past few years, researchers have tested these drugs on adults
who have attention disorders. Just as in children, the results show that
low doses of these medications can help reduce distractibility and
impulsivity in adults. Use of these medications has made it possible for
many severely disordered adults to organize their lives, hold jobs, and
care for themselves.                  
     In trying to do everything possible to help their children, many
parents have been quick to try new treatments. Most of these treatments
sound scientific and reasonable, but a few are pure quackery. Many are
developed by reputable doctors or specialists--but when tested
scientifically, cannot be proven to help. Following are types of therapy
that have not proven effective in treating the majority of children with
learning disabilities or attention disorders:                  
   * Megavitamins
   * Colored lenses
   * Special diets
   * Sugar-free diets
   * Body stimulation or manipulation                  
     Although scientists hope that brain research will lead to new medical
interventions and drugs, at present there are no medicines for speech,
language, or academic disabilities.                  
How Do Families Learn To Cope?                  
The effects of learning disabilities can ripple outward from the disabled
child or adult to family, friends, and peers at school or work.                  
     Children with LD often absorb what others thoughtlessly say about
them. They may define themselves in light of their disabilities, as
"behind," "slow," or "different."                  
     Sometimes they don't know how they're different, but they know how
awful they feel. Their tension or shame can lead them to act out in various
ways--from withdrawal to belligerence. Like Wallace, they may get into
fights. They may stop trying to learn and achieve and eventually drop out
of school. Or, like Susan, they may become isolated and depressed.                  
     Children with learning disabilities and attention disorders may have
trouble making friends with peers. For children with ADHD, this may be due
to their impulsive, hostile, or withdrawn behavior. Some children with
delays may be more comfortable with younger children who play at their
level. Social problems may also be a product of their disability. Some
people with LD seem unable to interpret tone of voice or facial
expressions. Misunderstanding the situation, they act inappropriately,
turning people away.                  
     Without professional help, the situation can spiral out of control.
The more that children or teenagers fail, the more they may act out their
frustration and damage their self-esteem. The more they act out, the more
trouble and punishment it brings, further lowering their self-esteem.
Wallace, who lashed out when teased about his poor pronunciation and was
repeatedly suspended from school, shows how harmful this cycle can be.                  
     Having a child with a learning disability may also be an emotional
burden for the family. Parents often sweep through a range of emotions:
denial, guilt, blame, frustration, anger, and despair. Brothers and sisters
may be annoyed or embarrassed by their sibling, or jealous of all the
attention the child with LD gets.                  
     Counseling can be very helpful to people with LD and their families.
Counseling can help affected children, teenagers, and adults develop
greater self-control and a more positive attitude toward their own
abilities. Talking with a counselor or psychologist also allows family
members to air their feelings as well as get support and reassurance.                  
     Many parents find that joining a support group also makes a
difference. Support groups can be a source of information, practical
suggestions, and mutual understanding. Self-help books written by educators
and mental health professionals can also be helpful. A number of references
and support groups are listed at the end of this booklet.                  
     Behavior modification also seems to help many children with
hyperactivity and LD. In behavior modification, children receive immediate,
tangible rewards when they act appropriately. Receiving an immediate reward
can help children learn to control their own actions, both at home and in
class. A school or private counselor can explain behavior modification and
help parents and teachers set up appropriate rewards for the child.                  
     Parents and teachers can help by structuring tasks and environments
for the child in ways that allow the child to succeed. They can find ways
to help children build on their strengths and work around their
disabilities. This may mean deliberately making eye contact before speaking
to a child with an attention disorder. For a teenager with a language
problem, it may mean providing pictures and diagrams for performing a task.
For students like Dennis with handwriting or spelling problems, a solution
may be to provide a word processor and software that checks spelling. A
counselor or school psychologist can help identify practical solutions that
make it easier for the child and family to cope day by day.                  
     Every child needs to grow up feeling competent and loved. When
children have learning disabilities, parents may need to work harder at
developing their children's self-esteem and relationship-building skills.
But self-esteem and good relationships are as worth developing as any
academic skill.                  
SUSTAINING HOPE                  
Susan is now in ninth grade and enjoys learning. She no longer believes
she's retarded, and her use of words has improved. Susan has become a
talented craftsperson and loves making clothes and furniture for her
sister's dolls. Although she's still in a special education program, she is
making slow but steady progress in reading and math.                  
Over the years, Wallace found he liked tinkering with cars and singing in
the church choir. At church, he met a woman who knew about learning
disabilities. She told him he could get help through his county social
services office. Since then, Wallace has been working with a speech
therapist, learning to articulate and notice differences in speech sounds.
When he complains that he's too old to learn, his therapist reminds him,
"It's never too late to work your good brain!" His state vocational
rehabilitation office recently referred him to a job-training program.
Today, at age 46, Wallace is starting night school to become an auto
mechanic. He likes it because it's a hands-on program where he can learn by
Dennis is now age 23. As he walks into the college job placement office, he
smiles and shakes hands confidently. After shuffling through a messy stack
of papers, he finally hands his counselor a neatly typed resume. Although
Dennis jiggles his foot and interrupts occasionally, he's clearly
enthusiastic. He explains that because tape-recorded books and lectures got
him through college, he'd like to sell electronics. Dennis says he'll also
be getting married next year. He and his fiancee are concerned that their
children also will have LD. "But we'll just have to watch and get help
early--a lot earlier than I did!"                  


Can Learning Disabilities Be Outgrown or Cured?                  
Even though most people don't outgrow their brain dysfunction, people do
learn to adapt and live fulfilling lives. Dennis, Susan, and Wallace made a
life for themselves--not by being cured, but by developing their personal
strengths. Like Dennis' tape-recorded books and lectures, or Wallace's
hands-on auto mechanics class, they found alternative ways to learn. And
like Susan's crafts or Wallace's singing, they found ways to enjoy their
other talents.                  
     Even though a learning disability doesn't disappear, given the right
types of educational experiences, people have a remarkable ability to
learn. The brain's flexibility to learn new skills is probably greatest in
young children and may diminish somewhat after puberty. This is why early
intervention is so important. Nevertheless, we retain the ability to learn
throughout our lives.                  
     Even though learning disabilities can't be cured, there is still cause
for hope. Because certain learning problems reflect delayed development,
many children do eventually catch up. Of the speech and language disorders,
children who have an articulation or an expressive language disorder are
the least likely to have long-term problems. Despite initial delays, most
children do learn to speak.                  
     For people with dyslexia, the outlook is mixed. But an appropriate
remedial reading program can help learners make great strides.                  
     With age, and appropriate help from parents and clinicians, children
with ADHD become better able to suppress their hyperactivity and to channel
it into more socially acceptable behaviors. As with Dennis, the problem may
take less disruptive forms, such as fidgeting.                  
     Can an adult be helped? For example, can an adult with dyslexia still
learn to read? In many cases, the answer is yes. It may not come as easily
as for a child. It may take more time and more repetition, and it may even
take more diverse teaching methods. But we know more about reading and
about adult learning than ever before. We know that adults have a wealth of
life experience to build on as they learn. And because adults choose to
learn, they do so with a determination that most children don't have. A
variety of literacy and adult education programs sponsored by libraries,
public schools, and community colleges are available to help adults develop
skills in reading, writing, and math. Some of these programs, as well as
private and nonprofit tutoring and learning centers, provide appropriate
programs for adults with LD.                  
What Aid Does the Government Offer?                  
As of 1981, people with learning disabilities came under the protection of
laws originally designed to protect the rights of people with mobility
handicaps. More recent Federal laws specifically guarantee equal
opportunity and raise the level of services to people with disabilities.
Once a learning disability is identified, children are guaranteed a free
public education specifically designed around their individual needs.
Adolescents with disabilities can receive practical assistance and extra
training to help make the transition to jobs and independent living. Adults
have access to job training and technology that open new doors of
Increased Services, Equal Opportunity                  
The Individuals with Disabilities Education Act of 1990 assures a public
education to school-aged children with diagnosed learning disabilities.
Under this act, public schools are required to design and implement an
Individualized Educational Program tailored to each child's specific needs.
The 1991 Individuals with Disabilities Education Act extended services to
developmentally delayed children down to age 5. This law makes it possible
for young children to receive help even before they begin school.                  
     Another law, the Americans with Disabilities Act of 1990, guarantees
equal employment opportunity for people with learning disabilities and
protects disabled workers against job discrimination. Employers may not
consider the learning disability when selecting among job applicants.
Employers must also make "reasonable accommodations" to help workers who
have handicaps do their job. Such accommodations may include shifting job
responsibilities, modifying equipment, or adjusting work schedules.                  
     By law, publicly funded colleges and universities must also remove
barriers that keep out disabled students. As a result, many colleges now
recruit and work with students with learning disabilities to make it
possible for them to attend. Depending on the student's areas of
difficulty, this help may include providing recorded books and lectures,
providing an isolated area to take tests, or allowing a student to tape
record rather than write reports. Students with learning disabilities can
arrange to take college entrance exams orally or in isolated rooms free
from distraction. Many colleges are creating special programs to
specifically accommodate these students.                  
     Programs like these made it possible for Dennis to attend and succeed
in college. The HEATH Resource Center, sponsored by the American Council on
Education, assists students with learning disabilities to identify
appropriate colleges and universities. Information on the HEATH center and
related organizations appears at the end of this brochure.                  
Public Agency Support                  
Effective service agencies are also in place to assist people of all ages.
Each state department of education can help parents identify the
requirements and the process for getting special education services for
their child. Other agencies serve disabled infants and preschool children.
Still others offer mental health and counseling services. The National
Information Center for Children and Youth can provide referrals to
appropriate local resources and state agencies.                  
     Counselors at each state department of vocational rehabilitation serve
the employment needs of adolescents and adults with learning disabilities.
They can refer adults to free or subsidized health care, counseling, and
high school equivalence (GED) programs. They can assist in arranging for
job training that sidesteps the disability. For example, a vocational
counselor helped Wallace identify his aptitude for car repair. To work
around Wallace's language problems, the counselor helped locate a
job-training program that teaches through demonstrations and active
practice rather than lectures.                  
     State departments of vocational rehabilitation can also assist in
finding special equipment that can make it possible for disabled
individuals to receive training, retain a job, or live on their own. For
example, because Dennis couldn't read the electronics manuals in his new
job, a vocational rehabilitation counselor helped him locate and purchase a
special computer that reads books aloud.                  
     Finally, state-run protection and advocacy agencies and client
assistance programs serve to protect these fights. As experts on the laws,
they offer legal assistance, as well as information about local health,
housing, and social services.                  


What Hope Does Research Offer?                  
Sophisticated brain imaging technology is now making it possible to
directly observe the brain at work and to detect subtle malfunctions that
could never be seen before. Other techniques allow scientists to study the
points of contact among brain cells and the ways signals are transmitted
from cell to cell.                  
     With this array of technology, NIMH is conducting research to identify
which parts of the brain are used during certain activities, such as
reading. For example, researchers are comparing the brain processes of
people with and without dyslexia as they read. Research of this kind may
eventually associate portions of the brain with different reading problems.                  
     Clinical research also continues to amass data on the causes of
learning disorders. NIMH grantees at Yale are examining the brain
structures of children with different combinations of learning
disabilities. Such research will help identify differences in the nervous
system of children with these related disorders. Eventually, scientists
will know, for example, whether children who have both dyslexia and an
attention disorder will benefit from the same treatment as dyslexic
children without an attention disorder.                  
     Studies of identical and fraternal twins are also being conducted.
Identical twins have the same genetic makeup, while fraternal twins do not.
By studying if learning disabilities are more likely to be shared by
identical twins than fraternal twins, researchers hope to determine whether
these disorders are influenced more by genetic or by environmental factors.
One such study is being conducted by scientists funded by the National
Institute of Child Health and Human Development. So far, the research
indicates that genes may, in fact, influence the ability to sound out
     Animal studies also are adding to our knowledge of learning
disabilities in humans. Animal subjects make it possible to study some of
the possible causes of LD in ways that can't be studied in humans. One NIMH
grantee is researching the effects of barbiturates and other drugs that are
sometimes prescribed during pregnancy. Another researcher discovered
through animal studies that certain prenatal viruses can affect future
learning. Research of this kind may someday pinpoint prenatal problems that
can trigger specific disabilities and tell us how they can be prevented.                  
     Animal research also allows the safety and effectiveness of
experimental new drugs to be tested long before they can be tried on
humans. One NIH-sponsored team is studying dogs to learn how new stimulant
drugs that are similar to Ritalin act on the brain. Another is using mice
to test a chemical that may counter memory loss.                  
     This accumulation of data sets the stage for applied research. In the
coming years, NIMH-sponsored research will focus on identifying the
conditions that are required for learning and the best combination of
instructional approaches for each child.                  
     Piece by piece, using a myriad of research techniques and
technologies, scientists are beginning to solve the puzzle. As research
deepens our understanding, we approach a future where we can prevent
certain brain and mental disorders, make valid diagnoses, and treat each
effectively. This is the hope, mission, and vision of the National
Institute of Mental Health.                  
What Are Sources of Information and Support?                  
Several publications, organizations, and support groups exist to help
individuals, teachers, and families to understand and cope with learning
disabilities. The following resources provide a good starting point for
gaining insight, practical solutions, and support. Further information can
be found at libraries and book stores.                  
Books for Children and Teens With Learning Disabilities                  
     Fisher, G., and Cummings, R. The Survival Guide for Kids with LD.
     Minneapolis: Free Spirit Publishing, 1990. (Also available on
     Gehret, J. Learning Disabilities and the Don't-Give-Up-Kid. Fairport,
     NY: Verbal Images Press, 1990.                  
     Janover, C. Josh: A Boy with Dyslexia. Burlington, VT: Waterfront
     Books, 1988.                  
     Landau, E. Dyslexia. New York: Franklin Watts Publishing Co., 1991.                  
     Marek, M. Different, Not Dumb. New York: Franklin Watts Publishing
     Co., 1985.                  
     Levine, M. Keeping A Head in School: A Student's Book about Learning
     Abilities and Learning Disorders. Cambridge, MA: Educators Publishing
     Services, Inc., 1990.                  
     Books for Adults With Learning Disabilities                  
     Adelman, P., and Wren, C. Learning Disabilities, Graduate School, and
     Careers: The Student's Perspective. Lake Forest, IL: Learning
     Opportunities Program, Barat College, 1990.                  
     Cordoni, B. Living with a Learning Disability. Carbondale, IL:
     Southern Illinois University Press, 1987.                  
     Kravets, M., and Wax, I. The K&W Guide: Colleges and the Learning
     Disabled Student. New York: Harper Collins Publishers, 1992.                  
     Magnum, C., and Strichard, S., eds. Colleges with Programs for
     Students with Learning Disabilities. Princeton, NJ: Petersons Guides,
     Books for Parents                  
     Greene, L. Learning Disabilities and Your Child: A Survival Handbook.
     New York: Fawcett Columbine, 1987.                  
     Novick, B., and Arnold, M. Why Is My Child Having Trouble in School?
     New York: Villard Books, 1991.                  
     Silver, L. The Misunderstood Child: A Guide for Parents of Children
     with Learning Disabilities: 2d ed. Blue Ridge Summit, PA: Tab Books,
     Silver, L. Dr. Silver's Advice to Parents on Attention-Deficit
     Hyperactivity Disorder. Washington, DC: American Psychiatric Press,
     Vail, P. Smart Kids with School Problems. New York: EP Dutton, 1987.                  
     Weiss, E. Mothers Talk About Learning Disabilities. New York: Prentice
     Hall Press, 1989.                  
     Books and Pamphlets for Teachers and Specialists                  
     Adelman, P., and Wren, C. Learning Disabilities, Graduate School, and
     Careers. Lake Forest, Learning Opportunities Program, Barat College,
     Silver, L. ADHD: Attention Deficit-Hyperactivity Disorder, Booklet for
     Teachers. Summit, NJ: CIBA-GEIGY, 1989.                  
     Smith, S. Success Against the Odds: Strategies and Insights from the
     Learning Disabled. Los Angeles: Jeremy Tarcher, Inc., 1991.                  
     Wender, P. The Hyperactive Child, Adolescent, and Adult. Attention
     Disorder through the Lifespan. New York: Oxford University Press,
     Related Pamphlets Available From NIH                  
     Facts About Dyslexia
     National Institute of Child Health and Human Development
     Building 31, Room 2A32
     9000 Rockville Pike
     Bethesda, MD 20892 (301) 496-5133                  
     Developmental Speech and Language Disorders--Hope through Research
     National Institute on Deafness and Other Communicative Disorders
     P.O. Box 37777
     Washington, DC 20013 (800) 241-1044                  
     Support Groups and Organizations                  
     American Speech-Language-Hearing Association
     10801 Rockville Pike
     Rockville, MD 20852 (800) 638-8255                  
   * Provides information on speech and language disorders, as well as
     referrals to certified speech-language therapists.                  
     Attention Deficit Information Network
     475 Hillside Avenue
     Needham, MA 02194 (617) 455-9895                  
   * Provides up-to-date information on current research, regional
     meetings. Offers aid in finding solutions to practical problems faced
     by adults and children with an attention disorder.                  
     Candlelighters Childhood Cancer Foundation
     7910 Woodmont Avenue, Suite 460
     Bethesda, MD 20814 (800) 366-2223                  
   * Provides information and support for children treated for cancer who
     later experience learning disabilities.                  
     Center for Mental Health Services
     Office of Consumer, Family, and Public Information
     5600 Fishers Lane, Room 15-81
     Rockville, MD 20857 (301) 443-2792                  
   * This new national center, a component of the U.S. Public Health
     Service, provides a range of information on mental health, treatment,
     and support services.                  
     Children with Attention Deficit Disorders (CHADD)
     499 NW 70th Avenue, Suite 308
     Plantation, FL 33317 (305) 587-3700                  
   * Runs support groups and publishes two newsletters concerning attention
     disorders for parents and professionals.                  
     Council for Exceptional Children
     11920 Association Drive
     Reston, VA 22091 (703) 620-3660                  
   * Provides publications for educators. Can also provide referral to ERIC
     Clearinghouse for Handicapped and Gifted Children.                  
     Federation of Families for Children's Mental Health
     1021 Prince Street
     Alexandria, VA 22314 703) 684-7710                  
   * Provides information, support, and referrals through federation
     chapters throughout the country. This national parent-run organization
     focuses on the needs of children with broad mental health problems.                  
     HEATH Resource Center
     American Council on Education
     1 Dupont Circle, Suite 800
     Washington, DC 20036 (800) 544-3284                  
   * A national clearinghouse on post-high school education for people with
     Learning Disabilities Association of America
     4156 Library Road
     Pittsburgh, PA 15234 (412) 341-8077                  
   * Provides information and referral to state chapters, parent resources,
     and local support groups. Publishes news briefs and a professional
     Library of Congress
     National Library Service for the Blind and Physically Handicapped
     1291 Taylor Street, NW
     Washington, DC 20542 (202) 707-5100                  
   * Publishes Talking Books and Reading Disabilities, a fact sheet
     outlining eligibility requirements for borrowing talking books.                  
     National Alliance for the Mentally Ill
     Children and Adolescents Network (NAMICAN)
     2101 Wilson Boulevard, Suite 302
     Arlington, VA 22201 (800) 950-NAMI                  
   * Provides support to families through personal contact and support
     meetings. Provides education regarding coping strategies; reading
     material; and information about what works--and what doesn't.                  
     National Association of Private Schools for Exceptional Children
     1522 K Street, NW Suite 1032
     Washington, DC 20005 (202) 408-3338                  
   * Provides referrals to private special education programs.                  
     National Center for Learning Disabilities
     381 Park Avenue South, Suite 1420
     New York, NY 10016 (212) 687-7211                  
   * Provides referrals and resources. Publishes "Their World" magazine
     describing true stories on ways children and adults cope with LD.                  
     National Information Center for Children and Youth with Disabilities
     P.O. Box 1492
     Washington, DC 20013 (800) 999-5599                  
   * Publishes newsletter, arranges workshops. Advises parents on the laws
     entitling children with disabilities to special education and other
     Orton Dyslexia Society
     Chester Building, Suite 382
     8600 LaSalle Road
     Baltimore, MD 21286-2044 (410) 296-0232                  
Answers individual questions on reading disability. Provides information
and referrals to local resources.                  
To arrange for special college entrance testing for LD adults, contact:                  
ACT Special Testing (319) 337-1332
SAT Scholastic Aptitude Test (609) 771-7137
GED (202) 939-9490                  
Research conducted and supported by the National Institute of Mental Health
(NIMH) brings hope to millions of people who suffer from mental illness and
to their families and friends. In many years of work with animals as well
as human subjects, researchers have advanced our understanding of the brain
and vastly expanded the capability of mental health professionals to
diagnose, treat, and prevent mental and brain disorders.                  
Now, in the 1990s, which the President and Congress have declared "The
Decade of the Brain," we stand at the threshold of a new era in brain and
behavioral sciences. Through research we will learn even more about mental
disorders such as depression, manic-depressive illness, schizophrenia,
panic disorder, and obsessive-compulsive disorder. And we will be able to
use this knowledge to develop new therapies that can help more people
overcome mental illness.                  
The National Institute of Mental Health is part of the National Institutes
of Health (NIH), the Federal Government's primary agency for biomedical and
behavioral research. NIH is a component of the U.S. Department of Health
and Human Services.                  
This booklet was written by Sharyn Neuwirth, M.Ed., an education writer and
instructional designer in Silver Spring, MD. Scientific information and
review was provided by NIMH staff members L. Eugene Arnold, M.D.; F. Xavier
Castellanos, M.D.; and Judith Rumsey, Ph.D. Also providing review and
assistance were Marcia Henry, Ph.D., Orton Dyslexia Society; Reid Lyon,
Ph.D., National Institute of Child Health and Human Development; Jean
Petersen, Learning Disabilities Association; and Larry B. Silver, M.D.,
Georgetown University. Editorial direction was provided by Lynn J. Cave,
All material in this publication is free of copyright restrictions and may
be copied, reproduced, or duplicated without permission from NIMH; citation
of the source is appreciated.                  



     U.S. Department of Health and Human Services
     Public Health Service                  
     National Institutes of Health
     National Institute of Mental Health                  
     NIH Publication No. 93-3611
     Printed 1993                  

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