Which of the following is most frequently postulated as a cause of learning disabilities?

Unlocking the Social and Emotional Enigmas of Dyslexia

By Michael Ryan, Clinical Psychologist

From the beginning, pioneers in the field of Learning Disabilities observed that many children with learning disorders struggled with anxiety and depression. The neurologist Samuel T. Orton (1937) was one of the first researchers to write about the emotional reactions some children have to dyslexia. Later, Richard Lewis and Alfred Strauss (1951) identified emotional problems as a symptom of certain learning disabilities. Similarly, early psychotherapists such as Phyllis Blanchard and Virginia Axline postulated that reading disorders were caused by emotional problems. Research has demonstrated that dyslexia is not caused by emotional problems. However, research indicates that as many as 20 percent of children with dyslexia also suffer from depression and another 20 percent suffer from an anxiety disorder (Willcutt, and Gaffney-Brown 2004). The majority of dyslexic children do not have an emotional disorder, but these children are more at risk than typical learners. Equally important is the data that suggests that when a child demonstrates this kind of comorbidity, both disorders are more severe and the child has more difficulty coping (Willcutt, and Gaffney-Brown 2004).

These are the dyslexic children who are getting the correct tutoring with an experienced teacher, but are learning more slowly then they should because shame or anxiety causes them to disconnect and thus, interrupts the learning process. Similarly, these are the college students with test anxiety who complete a comprehensive test desensitization program only to redevelop their test anxiety because their reading problems have not been addressed.

As the last issue of Perspectives demonstrated, heredity plays an important role in this comorbidity. However, the stress of being dyslexic also increases the child's susceptibility to anxiety and depression. Learning to read is one of the first developmental tasks society asks the child to accomplish outside of the home. This failure also interferes with the child's development of a positive self-image. Children with learning disabilities are also more likely to demonstrate deficits in social abilities and social skills. These deficits put them at odds with their peers' and family at a time when they need more support and empathy. Finally, dyslexia often produces many inconsistencies in the child's life. They may be gifted in some skills and terrible in other related skills. Furthermore, their cognitive skills fluctuate over time. This can produce what appears to be an intermittent disability which makes it difficult for the child to compensate and to understand.

Recently a mother came to my office with a large folder and desperation in her eyes. She wanted to talk to me about her bright, loving eleven-year-old daughter, Donna. Her folder was filled with reports from school psychologists, resource room teachers, ADHD clinics and Donna's psychotherapist. In spite of hundreds of hours with professionals, Donna was hurting herself. She was scratching and biting her arm until it bled.

After talking to Donna's mother and reviewing the reports, it was clear that Donna was an enigma that no one had been able to solve. Each report identified a different problem and the parents had diligently tried each intervention. Donna continued to fail at school, on the playground, and at home. For example, the ADHD clinic put Donna on medication but after about a year, her parents stopped the medication because it did not help her schoolwork.

The stress of this continued failure is affecting both Donna and her family. In addition to her scratching, Donna has become afraid to sleep alone. In the middle of the night she comes to her parent's room and wants to sleep with them. Her parents are frustrated; sleep deprived and cannot agree on how to handle her behavior. Of course, this stress affects Donna's younger sister.

My testing indicated that Donna is a well-related child of above average intelligence who suffers from severe dyslexia, an attention deficit disorder and anxiety disorder. Past professionals were correct in identifying specific problems but they missed the disorders outside their specialty and did not understand how these disorders interact. Donna's school recognized the learning disability but did not understand dyslexia as a unique learning disorder, so Donna did not receive the proper educational intervention. The medication helped Donna focus her attention. However, Donna could not read or spell, she continued to fail in school and became more anxiety ridden. Her psychotherapist understood anxiety disorders and ADD, but missed Donna's subtle language difficulties and her social deficits.

It is too early to know how Donna's story will end. However, I am hopeful that with increased insight and the proper combinations of interventions, Donna can find success and happiness.

Children with this kind of comorbidity are truly enigmas. In order to find solutions for these children, we must understand how learning disorders and emotional disorders interact and develop interventions that address the whole child. Contrary to popular belief, teaching and parenting learning disabled children is rocket science. It demands a complex understanding of the child's strengths and weaknesses in many areas. The good news is that this understanding is available. In fact, as a teacher, psychotherapist and parent of two learning disabled children; I believe that this is one of the most challenging and fulfilling tasks we can undertake.

I am honored to be the editor for Perspectives on this important topic. It has been a great pleasure to work with these gifted authors who will add insight on and concrete interventions for children who struggle with the comorbidity between dyslexia and psychiatric disorders. Kevin Blake will address the theory and practice of dealing with both social abilities and social skills. Wilson Anderson's article will help parents prioritize and teach social skills to their children with dyslexia. Gayle Zeimen covers the effect of dyslexia on the family. Finally, my article will offer ways we can help children deal more effectively with their feelings and develop self-discipline.

I am very excited about this issue of Perspectives and I hope it offers both in sights and concrete interventions to our readers in solving the enigmas of many dyslexic children.

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