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Learning disabilities, schools, and neurological dysfunction.

The field of learning disabilities (LDs) appears to many to be in a state of flux. Perhaps the best evidence in support of this position is the current discussion about how best to identify students with LDa--a summary of which can be found in the proposed rules and regulations for the Individuals with Disabilities Education Act (IDEA, Assistance to States for the Education of Children with Disabilities, 2005). In this document the United States government proposes that states discontinue the longstanding practice of identifying children with learning disabilities using a discrepancy between achievement and intellectual ability (i.e., IQ). Several alternative approaches are suggested. The frontrunners are response to intervention approaches in which students are identified as having LDs if they do not respond well to "high quality, research-based general education instruction" (p. 35802). Others include using some absolute level of low achievement, examining strengths and weaknesses in achievement, or looking for discrepancies within some subset of relevant cognitive skills (Assistance to States for the Education of Children With Disabilities, 2005). Moreover, echoing the work of Weatherley and Lipsky (1977), some researchers argue that, in addition to using such methods, we must begin to explicitly take into account the contexts within which teachers and administrators must make such decisions (e.g., Mellard, Deshler, & Barth, 2004).

And yet, despite these seemingly remarkable developments we argue the field is not really in a state of flux at all. For despite movement in the area of how best to operationalize the construct of LDs--movement that raises serious questions about the validity of the theoretical definition of LDs in school contexts--this definition has changed remarkably little since it was first inscribed into federal legislation in the United States in 1975. It is this stasis in the theoretical definition and in particular the assumption of neurological dysfunction as it relates to the construct of LDs in school contexts that is of interest to us presently. We begin with a brief review of the development of the definition of learning disabilities between 1962 and 1975--a time in which the original emphasis on LDs as an educational label concerned with teaching and learning more than cause, was lost in favor of an emphasis on etiology and a focus on differentiating children with "real" LDs from others who struggled in school. Then, we discuss some of the gains and losses associated with the LDs field's strong focus on etiology. Next, we explore some of the reasons etiology trumped education in the definition. We conclude with a discussion of the merits of the assumption of neurological dysfunction in school contexts and propose an alternative educational conceptualization of the construct.

That there are individuals who have neurobiologically based difficulties with learning in areas like reading, we believe, is undeniable at present (see for example Grigorenko, 1999; Hynd, Clinton, & Hiemenz, 1999; Olson, 1999; and Shaywitz & Shaywitz, 2003). However, that these individuals exist does not mean the category of learning disabilities, at least as currently conceptualized, makes sense in school contexts.

Early Definitions of Learning Disabilities

The field of learning disabilities has its roots in the neuropsychological research of the early to mid 20th century. A number of histories documenting the paths running from researchers like Gall and Hinshelwood to Orton and Monroe and from Goldstein to Werner and Strauss and ultimately to Samuel Kirk have been written (e.g., Carrier, 1986; Franklin, 1994; Hallahan & Mock, 2003; Hammill, 1993; Torgesen, 2004). We will not retrace that ground here. We begin instead in 1962 the year in which Kirk famously proposed the construct as follows:
 A learning disability refers to a retardation, disorder, or delayed
 development in one or more of the processes of speech, language,
 reading, spelling, writing, or arithmetic resulting from a possible
 cerebral dysfunction and/or emotional or behavioral disturbance and
 not from mental retardation, sensory deprivation, or cultural or
 instructional factors. (Kirk, 1962, p. 263)


While the assumptions that the disability is intrinsic to the child and likely neurobiological in nature are implicit in this definition, Kirk was explicit in his belief that this was an educational label first and foremost and that issues of etiology were less important than were issues of education. In the words of Kirk and Kirk (1971), "the term 'learning disability' is, then, primarily an educational concept. Its focus is on behavioral diagnosis and remediation rather than on biological etiology and the discovery of correlated central nervous system deficits" (p. 7). They went on to argue that,
 The concept of learning disability as used in education does not
 deny or reject a neurological deficit (acquired, genetic, or
 otherwise) but neither does it depend on a neurological
 determination. The major emphasis is on the use of psychological
 tests and/or observation for the purpose of organizing a remedial
 education program. Such a program is rarely dependent upon the
 determination of psychological abilities and disabilities. This
 concept has led to the use of the term "specific learning
 disability" instead of "brain damage" in psychoeducational circles,
 since the task is psychoeducational diagnosis and educational
 remediation. (pp. 12-13)


While Kirk appeared to believe that learning disabilities may have been caused by factors intrinsic to the child, he was clear that, as an educational construct, focusing on the etiology of the learning problems of students would not serve their educational needs well. Nonetheless, with the passing of P.L. 94-142 (The Education of the Handicapped Act) in 1975 the focus on the etiology of the learning difficulties was significantly more pronounced. The 1975 definition read as follows,
 Specific learning disability means a disorder in one or more of the
 basic psychological processes involved in understanding or in using
 language, spoken or written, which may manifest itself in an
 imperfect ability to listen, think, speak, read, write, spell or to
 do mathematical calculations. The term includes such conditions as
 perceptual handicaps, brain injury, minimal brain dysfunction,
 dyslexia, and developmental aphasia. The term does not include
 children who have learning problems which are primarily the result
 of visual, hearing, or motor handicaps, of mental retardation, of
 emotional disturbance, or for environmental, cultural or economic
 disadvantage. (cited in Torgesen, 2004, p. 22)


A little less than four decades later the definition has changed remarkably little:

(A) In general. The term "specific learning disability" means a disorder in 1 or more of the basic psychological processes involved in understanding or in using language, spoken or written, which disorder may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations.

(B) Disorders included. Such term includes such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.

(C) Disorders not included. Such term does not include a learning problem that is primarily the result of visual, hearing, or motor disabilities, of mental retardation, of emotional disturbance, or of environmental, cultural, or economic disadvantage. (Individuals with Disabilities Education Improvement Act, 2004)

In brief, while not stated explicitly, with its inclusion of words like brain injury and minimal brain dysfunction and its explicit exclusion of learning difficulties rooted in environmental, cultural, or economic disadvantage, the definition of LDs had and has a decidedly etiological focus.

What Was Gained, What Was Lost?

With thirty years of LDs under our collective belts, it is perhaps time to reflect on some of what was gained and lost when LDs became a part of the language and lives of children and schools.

What Was Gained?

Once the construct of LDs was written into federal legislation in the United States and policy in Canada it became a real disorder, an object of knowledge (Hacking, 1995)--something we could and did know about, something we could learn more about through research, and perhaps most importantly, something we could intervene against. In the process, we gained a new way to view others and ourselves, and a new way to disorder others and to be disordered ourselves. Of significance, this new way to disorder and be disordered rested somewhere between positive, or approved, and negative, or disapproved concepts in society (Hacking, 1998; Neufeld & Foy, 2006). More specifically, LDs rested somewhere between the concepts of "normality," on the positive side, and "mental retardation," on the negative side. As a consequence of this position, LDs proved to be a relatively palatable way to disorder others and to be disordered oneself. While carrying the LDs label was certainly no badge of honor, it was far less stigmatizing than carrying the label "mentally retarded" (Lyon et al., 2001). Evidence of this can be found in the growth of the category of LDs and the corresponding decline of the category of mental retardation in schools in the United States between 1976 and 1995. Between the 1976-1977 and 1994-1995 school years, the percentage of children (birth to 21 years) served by federal special education programs and that carried the LDs label increased from roughly 21 to 50 percent. During this same period the percentage of this same population of children that carried the mental retardation label decreased from approximately 27 to just over 10 percent (U.S. Department of Education, 1996).

Further, framing it as a construct focused on etiology, and rooted in the fields of neurology and neuropsychology, gave LDs scientific credibility. From this perspective LDs were real in a sense that was in keeping with the perspectives of disability and the self that have been historically dominant in the fields of medicine, psychology, and, indeed, education-perspectives that located disability within the individual and attributed it to some neurobiological defect or deficiency (Martin, 2004; Neufeld & Foy, 2006). This orientation was captured in the labels used in the 1940s and 1950s to describe children who today would likely carry the LDs moniker--labels like minimal brain dysfunction, brain injured, minimally brain damaged, perceptually impaired, and neurologically impaired (Franklin, 1994; Hallahan & Mock, 2003; Torgesen, 2004). Thus, as a type of disability, LDs could be easily assimilated into a larger taxonomy of disabilities that was already in place--it was just different enough to be interesting, but not so different that it disrupted a broader understanding of disabilities as intrinsic, neurobiologically based conditions.

As documented above, LDs became a popular disorder, and, as a result, we gained a new and specialized LDs industry. Very quickly individuals and institutions sprang up to support this new, or at least, retooled disability. Among others, there were organizations that developed tests to diagnose LDs; there were researchers who studied children with LDs and developed educational interventions for them; there were university programs that trained special educators to implement such interventions in schools; and, of course, there were school psychologists to diagnose children with LDs (see for example Carrier, 1986; Franklin, 1994; Hallahan & Mock, 2003; and Torgesen, 2004).

Moreover, the construct of LDs provided a coherent framework and single label around which parents and others advocating on behalf of students that were struggling in school could organize. In fact, it was immediately following Samuel Kirk's now famous speech in April of 1963 at a conference sponsored by the Fund for Perceptually Handicapped Children, that a vote was held and the Association for Children with Learning Disabilities (ACLD) was formed (Hallahan & Mock, 2003; Torgesen, 2004). The goal of this new advocacy organization "... was to mobilize social and political concern for the plight of children with learning disabilities and to create public sector services for them" (Torgesen, 2004, p. 15). In short, by clarifying the difficulties such children were facing, the LDs construct provided a strong nucleus around which advocates could mobilize their efforts to force schools to meet the needs of children who carried the label. As a consequence of the well-meaning efforts and very hard work of such advocates and others working in this new LDs industry we also gained specialized services for students who were struggling in school-services that benefited some and explicitly excluded others (a point we address later).

In sum, when the category of LDs was inscribed into the language and practices of our schools we gained a new and more palatable way to disorder others and to be disordered. Moreover, the field of LDs gained scientific credibility, an industry to support it, and a framework for advocacy action.

What Was Lost?

While it is undoubtedly the case that a subset of students benefited, academically at least, from the services afforded to them under the LDs label, in adopting an etiological approach a number of potentially fruitful avenues of conceptual inquiry and educational practice were overlooked, ignored, and/or actively suppressed. Moreover, for many individuals, carrying the label "learning disabled" is associated with a host of negative experiences, feelings, and perceptions. In the words of Aaron a 22-year-old who acquired the label at age 13,
 I am a prisoner, a survivor, a target, and a struggler,
 continuously defending, negating, and recreating myself. My
 disability? My disability is that I have been disabled, as well as
 discouraged and discounted by a temporarily able-minded, able
 --bodied general public. My success and failure have been based on
 an existing value system created by the dominant majority. Although
 I am now constantly disabling myself through a process of
 disbelief, exacerbating disabilities already in work, I know that I
 shouldn't be compared to anyone else. (Piziali, 2001, p. 31)


Arguably, it is, in part, the extreme intrinsic, etiological focus of the field of LDs that enables an "able-minded, able-bodied general public" to disable individuals like Aaron and is, thus, at the root of a number of the problems experienced by individuals who carry the label.

From the perspective of conceptual inquiry perhaps the most significant shortcoming of adopting an etiologically centered definition is that it imposed a LDs ontology that did not permit investigations into the nature of children's learning difficulties that strayed beyond the bounds of a narrow view of cognitive and neurobiological development (Speece, 1993). Such an approach ignores the broader context of human differences in learning creating the impression that the learning difficulties of children adhere to a simple trait model of cognitive development in which the distinctions between normal/abnormal and ability/disability are binary in nature and unaffected by context. A considerable body of research from a variety of fields including neurology (e.g., Galaburda, 1989; Mehler, 1989), cognitive neuroscience (e.g., Huttenlocher, 2002), developmental psychopathology (e.g., Sameroff, 1975; Sroufe, 1997), cognitive psychology (e.g., Adams, 1990; Shaywitz, Escobar, Shaywitz, Fletcher, & Makuch, 1992), and anthropology, and sociology too (e.g., Carrier, 1986; McDermott & Varenne, 1995; Skrtic, 1999), suggests that we may have closed the door on the question of etiology too soon and too tightly. Such an approach gives the misguided impression that LDs are strictly a matter of neurological dysfunction and, therefore, cannot be constructed and/or sustained through social interaction. Indeed, "... ecological factors have rarely been acknowledged, much less systematically investigated, in learning disabilities (Speece, 1993, p. 64). By interpreting LDs in this manner, not only did we misrepresent the role of contextual factors in LDs, we may have also misrepresented the nature of the psychological phenomena associated with them (Lyon et al., 2001). Moreover, adopting a simple trait model of LDs obscured the fact that learning difficulties whether rooted primarily in neurobiology, context, or some combination of the two are still real in the sense that they have an impact on people's lives.

In addition to suppressing a variety of avenues of conceptual inquiry, the strong etiological focus of the LDs field resulted in lost opportunities in the arena of educational practice. First, the causal focus of the definition of LDs and the manner in which it was operationalized created an artificial division between those who carry the label and other struggling learners who do not (Siegel, 2003; Shaywitz, Fletcher, & Shaywitz, 1994)--for instance, the learners described by Stanovich (1988) as "garden-variety poor readers" or the children we call "gray area students" in British Columbia. One consequence of this distinction was that some children who would benefit from the same kinds of support as children who carry the label were and are systematically excluded from receiving such services (Christensen, 1999).

Second, a variety of less than adaptive beliefs and practices are associated with the assumption of neurological dysfunction. Loss of agency on the part of individuals who carry the label (Elbaum & Vaughn, 2003; Piziali, 2001) and those who live and work with them (Skrtic, 1999) is one example. This is troublesome but understandable if the condition is viewed as intrinsic and neurobiological in nature. Unfortunately, this assumption may also be used to discharge teachers and/or caregivers from responsibility for causing, sustaining, or even facilitating the difficulties of learning exhibited by individuals who carry the LDs label. After all, by definition, LDs are caused by something within the child not something in her/his environment. Teachers and/or caregivers have no causal role to play here. Locating the problem within the child also served to limit the attention paid to potential explanations for a child's learning problems that rest in the context within which she/he lives and learns (Lyon et al., 2001; Speece, 1993).

Finally, research has documented how teachers refer students to special education based on a need for help rather than on some specific set of characteristics of the child (Gerber & Semmel, 1985; Zigmond, 1993). Thus, the ethics of many parents and educators were compromised when they were faced with the unenviable situation of having to attach a potent label to children that may or may not have fit in an effort to help them experience success in school.

To recap, adopting an etiological approach to LDs closed the door on research examining alternative explanations of school failure. As a consequence, we lost the potential to better understand the role played by contextual factors in constructing and/or sustaining the difficulties some children faced in school. Moreover, while the practice of LDs opened educational doors for some children who were struggling in school, for others it was a very negative practice, and, for better and worse, still others were locked out from the practice all together. Further, locating the cause of learning difficulties exclusively within the child resulted, in some instances, in a considerable loss of agency in children who carried the LDs label and the adults who lived and worked with them. Finally, it compromised the ethics of parents and educators who were faced with having to attach a label to children struggling in school in an effort to help them experience success.

Why Etiology Trumped Education in the Definition of LDs

Having discussed some of what was gained and lost in privileging etiology over education in the definition of LDs, we now address the issue of why etiology trumped education. Parents, educators, and others advocating for and/or working with children to whom we now attach the LDs label were well served by the focus on etiology. First, as we argued earlier, such a focus provided support for the argument that LDs were "real" in a sense that was in keeping with the perspectives of disabilities that were ascendant in the fields of medicine, psychology, and education-perspectives that located disability securely within the individual and viewed it as a product of some form of neurobiological dysfunction. There was a long tradition in the disabilities literature of looking to neurological foundations for the source of cognitive, affective, and behavioral difficulties of individuals; academic difficulties were presumed to fall under the same umbrella, to be studied, diagnosed, and cured in the same way as any other "medical" problem (Christensen, 1999; Hallahan & Mock, 2003; Martin, 2004; Torgesen, 2004).

Second, while it did not provide direct evidence that the relatively specific learning difficulties experienced by children who would ultimately carry the LDs label were neurobiological in nature, research documenting how focal brain lesions often resulted in loss of specific brain functions (Franklin, 1994; Torgesen, 2004) provided what was viewed as strong evidence that this was indeed the case. Moreover, if the genesis of the learning difficulties was within the child, then neither schools nor caregivers were at fault. Thus, a third reason etiology trumped education in the definition of LDs was that wittingly or unwittingly, LDs could be used to absolve schools, teachers, and/or caregivers from causing or inadvertently fostering the difficulties of learning experienced by the kinds of children who today carry the LDs label. Fourth, the specific brain--based etiological focus that came to characterize the LDs field provided a means by which to differentiate such children from others who were struggling in school-children like those whose difficulties were presumed to be environmental in origin and those whose difficulties were rooted in more globally dysfunctional brains (e.g., children with mental handicaps) (Shaywitz, Fletcher, & Shaywitz, 1994; Torgesen, 2004). Importantly, a variety of programs directed at addressing the educational needs of these other "types" of students were already in place in schools. Finally, the etiological focus of the LDs definition helped to sustain the argument that children with LDs needed educational interventions that were qualitatively different from those of children whose learning difficulties were rooted elsewhere--an argument that has not withstood the test of time well (Felton, 1993; Siegel, 1988, 1989; Torgesen, 2004). In the words of Christensen (1999), "there has been a failure to identify instructional methods that are specifically effective for students with learning disabilities" (p. 232).

In short, etiology trumped education in the definition of learning disabilities because it kept the view of LDs in line with perspectives on disability that were dominant in the fields of medicine, psychology, and education; a growing body of research suggested that specific learning difficulties could be based in aberrant brain structures and/or functions; and it could be used to absolve teachers, schools, and/or caregivers from playing a causal or facilitative role in the learning difficulties of children who were assigned the label; to differentiate children who carried the label from others who struggled in school; and to support arguments for exclusive interventions for children who carried the LDs label.

Conclusion

Shortly after coining the term learning disabilities, Samuel Kirk warned that the growing emphasis on neurobiological causality was misplaced as it diverted attention away from a more appropriate focus on how best to meet the educational needs of a group of students that were not well served by schools. Despite Kirk's concerns, we opted for an etiologically oriented definition. Some in the field of LDs argue that we are on the right track, that we only need more nuanced approaches for diagnosing LDs (e.g., Scruggs & Mastropieri, 2002; Mellard, Deshler, & Barth, 2004). This position is supported in the Individuals with Disabilities Education Improvement Act of 2004 and the proposed rules and regulations that support it. From this perspective, the problem is not with the theoretical definition of LDs, but instead with the way it is operationalized and practiced in schools. We do not agree. In our view, the lessons of the past 30 years suggest Kirk's concerns were well founded and it is now time to revisit the foundational assumptions upon which the practice of LDs in schools rest. A considerable body of research from a number of different disciplines supports the argument that in educational contexts a focus on etiology is indeed misplaced. There is simply no need for the kind of grand structuralist theorizing that has characterized the practice of LDs in schools to date. Moreover, in our opinions, such research suggests that it is time to pursue a more modest and less precise means by which to conceptualize the struggles of students in schools--one that does not deny that some children are neurobiologically predisposed to struggle in areas like learning to read, but one that also recognizes and seeks to understand and address the contextual factors that conspire to construct and sustain such difficulties. What is needed in educational contexts, then, is a functionalist conceptualization of LDs that remains close to the activities of learners and the contexts in which such activities unfold. Interestingly, many, if not all, the recent proposals regarding how best to operationalize the construct of LDs are in keeping with such a stance (Assistance to States for the Education of Children With Disabilities, 2005; Mellard, Deshler, & Barth, 2004).

Importantly, none of the above should be taken to imply that it is not potentially useful to identify the performative differences experienced by learners that struggle in school. Instead, the argument is that the manner of conceptualizing LDs and the pedagogical consequences of such a conceptualization need to be shifted from the narrow realm of psychic neural structures to the practical realm of pedagogical structures and exchanges. In essence, then, we are arguing for a transformation in the interpretations of the difficulties such students experience.

Although a detailed discussion of the implications of adopting an educationally oriented approach to the subject is beyond the scope of the present analysis, there are several broad points or implications for practice that can be made. First, such a definition would not enable schools to exclude struggling students from potentially beneficial intervention programs based on a nebulous and educationally unimportant assumption that their learning problems were rooted in their environments rather than their brains. Second, eliminating causal claims from the LDs definition in school contexts would eliminate the ethical dilemma educators and parents face when they must attach to a student the LDs label with its attendant assumption of neurological dysfunction--an assumption that may not hold true--for the student to receive badly needed educational services. Third, adopting an educationally oriented definition of LDs would likely help refocus schools' and educators' attention away from cause and towards areas under their immediate influence--areas like instructional contexts and pedagogical practices. This refocusing, in turn, would have the potential to increase the agency of schools, teachers, and parents regarding their potential to obviate the learning challenges faced by children to whom the LDs label was attached. At the same time, this retooled theoretical definition might help schools, teachers, and parents to consider the possibility that they may unintentionally have played some casual or facilitative role in the learning challenges of a learner with the LDs label.

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Paul Neufeld

Simon Fraser University

Seanna Takacs

Simon Fraser University
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Author:Neufeld, Paul; Takacs, Seanna
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Date:Dec 22, 2006
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