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Poor scholastic performance and its relation to specific learning disabilities among school children in mysore.

INTRODUCTION: The National Joint Committee on Learning Disabilities defines the term learning disability as: "a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities. These orders are intrinsic to the individual and presumed to be due to central nervous system dysfunction. Even though a learning disability may occur concomitantly with other handicapping (eg. Sensory impairment, social and emotional disturbances) or environmental influences; it is not the direct result of those conditions or influences."

Specific learning disabilities are Reading disability or "dyslexia", writing disability or Dysphasia/aphasia and math disability or "dyscalculia". There is no single cause to explain the origin of learning disabilities, variety of factors have been linked with its occurrence such as genetic, biochemical, biological, unfavourable uterine environment and environmental deprivation.

In India, the learning disability movement is only a decade or two old. We lag behind the western world in this regard by around 50 years. During the last decade, the movement has definitely picked up momentum and more and more children with this 'invisible handicap' are being identified.

In spite of this, there is paucity of epidemiological studies conducted in India to determine the exact prevalence of scholastic backwardness, in general, and Specific Learning Disability (SLD), in particular. [1]

The incidence of dyslexia in primary school children in India has been reported to be 2-18%, of dysgraphia 14%, and of dyscalculia 5.5%. {17-19} However, awareness that specific learning disabilities is an important cause of academic underachievement has recently increased. [2]

Many studies have been done worldwide in order to find out the prevalence of specific learning disabilities in school going children. In India Dr. Sunil Karande and his team studied the Clinical and Psychoeducational profile of children suffering with Specific Learning Disabilities (SpLD) and co-occurring Attention Deficit Hyperactivity Disorder (ADHD); author stressed on the fact that the children with SpLD have to be recognised early to prevent the poor school performance and associated social and mental difficulties a child might face as a result of it. [3]

In another study Dr. Karande and his team compared the cognition abilities of children who were diagnosed with SpLD with a group of normal children and the observations made in the study were that the children with SpLD had significantly lower scores in all four areas of information, maximally in the symbolic area followed by semantic, figural and behavioural areas. From the results the authors could conclude that cognition abilities are significantly impaired in children with SpLD. [4]

In the study on prevalence of specific arithmetic disabilities and specific reading disabilities in 9 and 10 yrs old children it was found that results were contrary to some previous reports, there were equal numbers of males and females within each of the two groups with arithmetic difficulties but a preponderance of males over females amongst the group with specific reading difficulties. [5]

In another study about the prevalence of combined reading and arithmetic disability and found that differ processes underlie the relationship between arithmetic and word recognition disabilities compared to the relationship arithmetic disabilities with difficulties in spelling and reading comprehension. [6]

There is a study on the prevalence of reading disability in early elementary school: impact of socioeconomic environment on reading development in three different educational zones and concluded that the high rate of children with a significant delay in reading depended on general socioeconomic environment. [7]

Study on the prevalence of dyslexia in first to sixth grade students was concluded that dyslexia was a common problem among primary school students. [8]

METHODS:

Study Subjects: Students were selected using Simple Random Sampling method.

A. Inclusion Criteria:

* Students who satisfy the criteria for poor scholastic performance, which is, scoring less than 45% marks or equivalent grades for the past 2 years or more

* Students aged between 8-12 yrs.

B. Exclusion Criteria:

* Students whose parents do not give consent.

METHODOLOGY: A list of government and semi-aided schools was obtained from the office of the block education officer. A permission letter was also taken from the office of the Deputy Director of Public Instruction to carry out the study in various schools of Mysore city. Students with poor scholastic performance, aged between 8-12yrs, were recognized. Poor scholastic performance, for the purpose of this study, has been defined as scoring less than 45% marks or equivalent grades over two or more consecutive academic years.

The selected students were administered the NIMHANS Index for Specific Learning Disability, after taking due informed consent, for the interview, from the parents. Based on the results of the test the students were classified as:

* Normal (without any learning disability or difficulty).

* With Specific Learning Difficulty(the students who performed at the level of one or two standards below the standard they were studying in). [1]

* With Specific Learning Disability(the students who performed at the level of three standards or more below the standard they were studying in). [1]

STATISTICS: Descriptive statistics like mean and standard deviation was used SPSS 16 package was used for the analysis of data.

RESULTS: From the list of the school shortlisted in Mysore city two government schools and two semi-aided schools were selected. Gender distribution of study subjects was 63.4% were males and 36.6% were females, 28 (68.2%) of the 41 subjects are from class 4th and 5th (table 1). The mean age of all the participating 10.68yrs [+ or -] 0.67 majority of the subjects are aged 10 yrs (n=15) (table 1) and difference in mean weight among the gender in each class was insignificant (table 1). Majority of fathers are semi-professional or clerical workers (n=31) none of the fathers is a semiskilled or unemployed.

On physical examination to check signs of anemia it is found that pallor was present in 33 out of 41 subjects (80.5%) and the percentage of girls and boys having pallor is almost the same Most of the study subjects had hemoglobin concentration between 8-9.9gm/dl indicates that these subjects had moderate anemia (table 2).

On assessing learning parameters it is found that in performance of the normal subjects, number of mistakes and omissions increased as the standard of the subject increased and number of correct cancellations also increased with the standard of the subject (table 3).

Study subjects were assessed for reading skills, writing skills, mathematical skills, auditory memory, and Visual memory, and it is found that:

* Out of all the subjects only 2 had learning disability in reading 4 students also had a learning difficulty in reading (table 4).

* None of the subjects had any learning disability or difficulty in writing and 24 subjects had a learning difficulty in mathematics and 2 students had learning disability in mathematics (table 4). So prevalence of learning difficulty in mathematics was 58% and prevalence of learning disability in mathematics was 4.8%.

* All subjects except 2 had adequate auditory memory and all the subjects have adequate visual memory (table 5).

When learning backwardness among children with poor scholastic performance was assessed it was found that most subjects have a learning difficulty in maths and none of the subjects have any difficulty in writing and on classifying the learning disabilities it is found that 22 subjects have a specific learning difficulty and 2 subjects have specific learning difficulty (table 6).

DISCUSSION: It is known fact that all children suffering from specific learning disabilities do not do well academically. Some studies have confirm that a large percentage of school dropouts in India are due to unsatisfactory academic performance, nearly half of the children and adolescents in urban slums fare poorly in school and that a significant number of the low birth weight babies in India are at risk of scholastic backwardness.

It may not be inappropriate to estimate the prevalence as the same or slightly more than the western figure of 20% of the child and adolescent population. [1]

School and study subject profile: 63.4% of the study subjects were males and the mean age of the study subjects was found to be 10.68 yrs, with a standard deviation of 0.67. Majority of the subjects studied in class 4th and 5th. It was observed that more number of male students performed poorly in school than female students. Dr. Sunil Karande et al, in their study about the clinical and psycho-educational profile of children with Specific Learning Disordern (SpLD), found that there was no difference in the profile of the male and female subjects. [3]

Lewis C et al also commented, in their study, that SpLDs are not common in one gender or the other. [6] In this study, however, none of the subjects was known to have any SpLDs. The study subjects in the study were chosen from an age group of 8-12 yrs. The children below the age of 8 yrs can only have a learning difficulty in specific area and no learning disability. Only children above the age of 8 yrs can be diagnosed as having a learning disability. [9]

General physical health of the study subjects: Most of the study subjects showed pallor. This may suggest that they were anemic. Weights of all the subjects were recorded. All the subjects were within the 10th percentile of their expected weigh according to the WHO standards.

Attention test: The test results of the study subjects were compared with the results obtained when the test was administered to normal subjects. [9] It was observed that all the study subjects made more number of mistakes, more number of omissions and had less number of correct answers. It was also observed that the subjects found it difficult to complete the test. The method they used to complete the test was not organized and they were haphazard in their approach.

From the results we may conclude that the students with Poor Scholastic Performance had a difficulty in concentrating, and focusing their attention on the task at hand. Dr. Sunil Karande et al had observed that 96% of the subjects with Specific Learning Disabilities, they studied had attention problems. [2] Lack of attention could be the cause of their Poor Scholastic Performance.

Reading, writing and mathematical skills: Most of the subjects in this study did not have any problems in reading performed, at the level of the class they were studying in. Only two subjects were found to have specific learning disability of reading. One of them was a student of class 6th and performed at the level of class 2nd another student was a student of class 5th and performed at the level of class 2nd. Both these subjects were males. All the study subjects performed adequately on the writing tests. They could copy easily from the given comprehensions.

They made very few errors like missing a letter, or substituted a letter or adding of letters. mathematics turned out to be the most difficult for most of the subjects. Out of the 41 subjects, 22 had a specific learning difficulty in mathematics and 2 of the subjects had specific learning disability.

The same students who suffered from learning disability in reading also suffered from learning disability in mathematics. Lewis C, Hitch GJ, Walker P. Department of Psychology, University of Lancaster, U.K. found in their study that there was a 2.6% co-occurrence of mathematical learning disability with that of reading disability. In this study there was a 100% co-occurrence. [6]

Auditory and visual memory: Almost all the study subjects had performed adequately on the memory tests except two. These were the same students, who also suffered from learning disability in mathematics and reading. For the visual memory the subjects could recollect more than 8 objects in the first attempt.

CONCLUSION: Poor scholastic performance is a problem among many school children in India. The causes for the same are not elicited many a times. Specific learning disabilities could be coming in the way of academic progress in these children. All the stake holders like parents; teachers should screen the underperforming students for the presence of specific learning disabilities and initiate treatment and support mechanisms.

KEY MESSAGE:

What is already known?

Children with specific learning disorders have difficulty coping up, academically with their fellow classmates.

What Study says?

Specific learning difficulties and disabilities are troubling many students and they are going undetected in our setting and are causing scholastic backwardness among them.

DOI: 10.14260/jemds/2014/2754

REFERENCES:

[1.] Naveen Thacker. Poor scholastic performance in children and adolescents Indian Pediatrics 2007; 44: 411-412.

[2.] Dr. Sunil Karande, Madhuri Kulkarni. Specific Learning Disability: The Invisible Handicap Indian. Journal of pediatrics 319, volume 42, April 17, 2005.

[3.] Karande [S.sup.1], Satam N, Kulkarni M, Sholapurwala R, Chitre A, Shah NIndian J Med Sci. Clinical and psychoeducational profile of children with specific learning disability and co-occurring attention-deficit hyperactivity disorder, 2007; Dec; 61(12) :639-47.

[4.] Sunil Karande, Sulaxana Sawant, Madhuri Kulkarni, Sandeep Kanchan and Rukshana Sholapurwala, Cognition in specific learning disability. Indian Journal of Pediatrics; 2005; 72; 1029-34.

[5.] Lewis [C.sup.1], Hitch GJ, Walker P. The prevalence of specific arithmetic difficulties and specific reading difficulties in 9- to 10-year-old boys and girls. J Child Psychol Psychiatry. 1994 Feb; 35 (2): 283-92.

[6.] Dirks [E.sup.1], Spyer G, van Lieshout EC, de Sonneville L. Prevalence of combined reading and arithmetic disabilities. J Learn Disabil. 2008, Sep-Oct; 41 (5): 460-73.

[7.] Fluss [J.sup.1], Ziegler J, Ecalle J, Magnan A, Warszawski J, Ducot B, Richard G, Billard C Prevalence of reading disabilities in early elementary school: impact of socioeconomic environment on reading development in 3 different educational zones. Arch Pediatr. 2008, Jun; 15(6): 1049-57.

[8.] Roongpraiwan [R.sup.1], Ruangdaraganon N, Visudhiphan P, Santikul K. Prevalence and clinical characteristics of dyslexia in primary school students. J Med Assoc Thai. 2002; Nov; 85 Suppl 4: S1097-103.

[9.] Sam D. Clements, John E. Peters, Minimal Brain Dysfunctions in the school-Age Child Diagnosis and Treatment Arch Gen Psychiatry. 1962; 6 (3): 185-197.

AUTHORS:

(1.) Manjunatha S. N.

(2.) Revathi Devi M. L.

(3.) Manu Suresh Sharma

PARTICULARS OF CONTRIBUTORS:

(1.) Assistant Professor, Department of Community Medicine, MMC & RI.

(2.) Professor and HOD, Department of Physiology, MMC & RI.

(3.) Final Year MBBS Student, Department of Community Medicine, MMC & RI.

NAME ADDRESS EMAIL ID OF THE CORRESPONDING AUTHOR:

Dr. Manjunatha S. N, Assistant Professor, Department of Community Medicine, Mysore Medical College and Research Institute, E-mail: manjunatdr@gmail.com drmanju.mmcri@gmail.com

Date of Submission: 24/05/2014. Date of Peer Review: 25/05/2014. Date of Acceptance: 27/05/2014. Date of Publishing: 05/06/2014.
Table I: Distribution of study subjects based on Gender and age,
Mean weight of the subjects:

Gender wise

STD     Male   Female   Total

STD-3    3       1        4

STD-4    7       7       14
STD-5    12      2       14
STD-6    4       5        9
TOTAL    26      15      41

Age wise

Age      Male   Female   Total

9Yrs      2       1        3

10Yrs     8       7       15
11Yrs     10      1       11
12Yrs     6       6       12
TOTAL     26      15      41

Weight    STD          Mean weight
                      (in Kg + SD)

                    MALE       FEMALE

         STD-3    19.5+0.5       19
         STD-4     21+1.3     20.7+1.5
         STD-5    24.04+1.7   23.5+2.6
         STD-6    26.5+3.2    25.5+4.6

* STD = Standard ** SD = standard deviation

Table II: Physical signs of Anemia and Hemoglobin concentration in
study subjects:

Pallor

Pallor       Male   Female   Total

Present       21      12      33
Absent        5       3        8
Total         26      15      41

Haemoglobin Concentration

Hb           Male   Female   Total

6-7.9gm/dl    0       0        0
8-9.9gm/dl    4       1        5
10-12gm/dl    1       0        1
>12gm/dl      0       0        0
Total         5       1        6

Hb = haemoglobin

Table III: Number cancellation test:

Subjects                          STD-3                STD-4

                          C      W       O       C      W      O

Performance of    MEAN   32.4   1.2     8.2    38.9    0.8    23.4
Study Subjects    SD     7.1    0.43    3.8    11.42   0.21   8.9
(n=41)

Performance of    MEAN   39.7   0.19    4.6     46     0.02   15.5
Normal Subjects   SD     9.85   0.7    12.47   10.3    0.16   26.4
(n=40)

Subjects                          STD-5                 STD-6

                           C      W       O      C      W      O

Performance of    MEAN   46.7    1.6    22.6    47.1   0.7    21.7
Study Subjects    SD     18.19   0.32   23.12   15.8   0.55   14.8
(n=41)

Performance of    MEAN   59.1    0.2    10.48   60.2   0.19   9.8
Normal Subjects   SD     16.78   0.22   18.7    12.4   1.19   18.7
(n=40)

* C= no. of correct ** W= no of wrong *** O = no of omitted

Table IV: Reading, writing and mathematical skills of study subject:

Skills               STD-3 (%)         STD-4 (%)

                 AD    LF    LD    AD     LF    LD

Reading skills   9.8    0    0    34.1    0     0
(n=41)

Writing skills   9.8    0    0    34.1    0     0
(n=41)

Mathematical     7.3   2.4   0     22    12.2   0
skills (n=41)

Skills                 STD-5 (%)           STD-6 (%)

                  AD     LF    LD     AD     LF    LD

Reading skills   29.3   2.4    2.4   14.6   4.9    2.4
(n=41)

Writing skills   34.1    0      0     22     0      0
(n=41)

Mathematical     4.9    26.8   2.4   7.3    12.2   2.4
skills (n=41)

* STD= standard ** AD=adequate *** LF= Learning difficulty **** LD=
Learning disability

Table V: Memory level of study subjects:

Memory             STD-3 (%)   STD-4 (%)   STD-5 (%)     STD-6 (%)

                  AD    IND   IND    AD    AD    IND    AD    IND

Auditory Memory   9.8    0    34.1   0    31.7   2.4   19.5   2.4
  (n=41)
Visual Memory     9.8    0    34.1   0    34.1    0     22     0
  (n=41)

* AD = Adequate ** IND = Inadequate

Table VI: Classification of learning disabilities and learning
backwardness among children with poor scholastic performance:

Learning problem      Male   Female   Total   Performance
                                              of study
Learning difficulty    13      9       22     subject

Learning disability    2       0        2
No problem             11      6       17
Total                  26      15      41

Learning problem        Reading (n=41)    Writing (n=41)

Learning difficulty    AD    LF    LD    AD    LF   LD

Learning disability   87.8   7.4   4.8   100   0    0
No problem
Total

Learning problem          Maths (n=41)

Learning difficulty    AD     LF    LD

Learning disability   41.6   53.6   4.8
No problem
Total

* AD=adequate ** LF= Learning difficulty *** LD= Learning disability
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Title Annotation:ORIGINAL ARTICLE
Author:Manjunatha S.N.; Revathi, Devi M.L.; Sharma, Manu Suresh
Publication:Journal of Evolution of Medical and Dental Sciences
Date:Jun 9, 2014
Words:3052
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