In recent years, we have witnessed an important increase in the diagnosis of Specific Learning Disorders (SLD). This certainly denotes greater attention from teachers and families who identify and report a child and/or adolescent’s difficulty in school.
For more than eight years, I have been working as a speech therapist. My professional skills concern neurorehabilitation specifically for adults in patients with severe acquired brain injury and neurodegenerative diseases.
When I was presented with the Papillon project, I immediately felt the certainty that I could also venture towards a reality that I previously had often put aside because the way in which it had been approached did not fully correspond to my way of thinking. Now, I had the opportunity to try my hand at something new in the context of developmental age and adolescence.
We hear a lot about them, but what are SLDs and how are they defined?
SLDs are defined as SPECIFIC disturbances falling into the category of SEN (Special Educational Needs). This denomination is due to the tendency to think that they selectively concern some learning processes, although it is more likely to note that when a child has reading and writing difficulties, these are almost always associated with calculation problems and difficulties, of attention and concentration.
Can we consider these “specificities” as unique and individual peculiarities of each person, as a set of predispositions and characteristics?
These disorders are described in DSM IV first as “Disorders of onset in infancy, childhood”; in the DSM V “Neurodevelopmental Disorders”, where the organic element is less present but they are still considered neurobiological disorders, referring to a multifactoriality between biological and environmental aspects.
The Consensus Conference on SLD of 12/2010 promoted by the Ministry of Health affirmed, with reference to specific learning disorders, that: “… to date the wealth of knowledge produced by the international scientific literature presents areas of ambiguity and uncertainty, due to either the scarcity of available scientific data or their non-concordance… ”, defining these disorders as chronic neurobiological dysfunctions.
The Consensus Conference itself encouraged an in-depth study of this area.
Regarding dyslexia, a study identifies the responsibility of chromosome 15; however, the same study states that the genes that determine this difficulty have not been identified neither with certainty nor if this difficulty arises from errors in perception of the graphic signs of writing, the association between these signs and the sounds that correspond to them, or a lack of attention span.
Law 170 of 2010 recognizes dyslexia, dysgraphia, dysorthography and dyscalculia as specific learning disorders that occur in the presence of adequate cognitive abilities, in the absence of neurological pathologies and sensory deficits, but can constitute an important limitation for some activities of daily living. Therefore, “didactic support measures” are envisaged.
A similar situation, with a continuously increasing diagnosis, occurs for ADHD (Attention deficit and hyperactivity disorder); children considered to be too lively, with a behavioral disorder, who are frequently treated with the administration of drugs and who too often become very problematic adolescents and/or adults if the intervention is not valid from an early age.
The Ministry of Health expresses itself as follows: “… it is a disorder of the neuropsychic development of children and adolescents, characterized by inattention, impulsivity, hyperactivity … the exact cause of ADHD is not known but some studies seem to suggest a role of some genes (in particular those that control the level of brain neurotransmitters, such as dopamine) that, interacting with some environmental and social factors, could give rise to this disorder: it is therefore a multifactorial syndrome “… The diagnosis of ADHD is clinical, that is, it is based on the doctor’s evaluation of symptoms … “
Can we ask ourselves some questions?
Where hyperactivity, inattention and impulsivity are symptoms, is it possible to identify the cause?
In consideration of the fact that a person has intelligence and cognitive abilities appropriate to his/her age, it is necessary to understand the underlying cause for the manifestation of a symptom.
It is important not only to consider that each individual has unique characteristics, their own predispositions and/or interests, but also that the times and methods of learning may vary from person to person for different reasons.
We are talking about children who, through school, move away from their emotional nucleus for the first time and who very often are unable to verbalize their difficulties, insecurities, fears.
Children who, as they grow up, have to face an important change and for which they are not always ready; these changes can interfere with learning and behavior.
Furthermore, it often happens that some young people experience these diagnoses as a “label”, in some this triggers a thought of unchangeability that could generate a sense of failure, low self-esteem and the fear of having innate incapacities.
Emotions play a fundamental role in our life, which is why the approach we choose to use in intervening and the goal we aim for are important.
For what has been said so far, it is of fundamental importance for me that one not only take care of the child from several points of view, but also the family and the school as an active part of the process; this is also because, in affixing labels, in an attempt to describe a difficulty, one could run the risk of de-empowering figures who instead have a lot of importance in the evolution and growth of each individual.
With regard to this last statement, it is necessary to clarify immediately that in these situations a “culprit” is never sought but rather the origin of a discomfort and the best way to deal with it, not only with the intervention of professionals from various sectors, but also through interaction and human relationships, which remain at the basis of all of our lives.
These considerations have the sole purpose of underlining how fundamental the collaboration between all the people that revolve around the development of children is as they are born with the total confidence that another human being will take care of them and love them in an unconditional way allowing them to grow, free from not having to resemble anyone but themselves.
I think what really matters is that whatever “technique” we choose to carry out our intervention, this must be based on a way of thinking that rings true and corresponds to us, continuing to ask questions where the answers are not always clear and exhaustive.
P.S. The revision of the joint monothematic document FLI (Federation of Italian Speech Therapists) and SSLI (Scientific Society of Italian Speech Therapists) “Communication and linguistic aspects in the assessment and treatment of Specific Learning Disorders” has been published in these days.
With this (subsequent in terms of time to the writing of my article which contains my thoughts on this for a long time) it is hoped that there can really be a substantial change in the developmental age and that these difficulties or frailty of the youngest children are recognized and treated by attributing the right importance to multidisciplinary intervention, psychological aspects, adequacy of exposure to correct stimulations, individual characteristics and observation of the different evolutionary stages of children also in terms of prevention.
Papillon will be online starting November 20, World Day of the Rights of Children and Adolescents. It is just a coincidence, but it bodes well.
Valeria Verna
Thanks to Ray Williams for the translation of this article.
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