Navigating school or occupational challenges faced by children with learning disabilities and muscular dystrophy (MD) can feel overwhelming. However, understanding how these two things are linked can help you or the individual you care for connect with the right support.
MD is an umbrella term for a class of genetic disorders characterized by progressive muscle weakness. Although MD primarily affects muscle health, certain types significantly impact learning, cognition, and behavior.
Spotting learning disabilities early, communicating with schools about accommodations, and putting in place targeted strategies at home can help your child adapt and thrive. This guide covers the signs of a learning disability, how to access the right evaluation, and ways to build collaborative, supportive home and school environments.
What are learning disabilities?
Learning disabilities are neurological processing problems that make acquiring skills or knowledge more challenging. They also impact the ability to learn foundational skills, such as reading, writing, or doing math. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, learning disabilities can develop in those with normal or above-average intelligence.
These disabilities can also interfere with organizational skills, time management, abstract reasoning, memory, and attention span. Some people with learning disabilities have a difficult time interacting with others and building relationships.
Learning disabilities are different than intellectual and physical disabilities:
- Intellectual disabilities involve impairments in a person’s ability to learn, solve problems, and reason, as well as social and life skills.
- Physical disabilities describe issues with the skeletal, muscular, or nervous system that affect a person’s ability to move, hold objects, or maintain activities for a normal duration, rather than the ability to process or absorb information.
How can MD affect learning?
Researchers are still exploring what causes learning disabilities associated with MD. They do not develop in everyone with MD. However, some research provides a framework for understanding the condition’s possible impact on brain function. MD’s effects elsewhere in the body can also affect a person’s ability to navigate school life.
Around 2 to 3 in 10 people with Duchenne Muscular Dystrophy (DMD), the most common type, meet clinical guidelines for a specific learning disability. Often, DMD learning disabilities mainly affect an individual’s ability to remember verbal information in the short term, working memory, and executive function, or a person’s ability to make plans, adapt to new situations, and solve problems.
Research also suggests that children with DMD have higher rates of neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD), anxiety, and autism spectrum disorder.
Childhood myotonic dystrophy can also lead to learning disabilities and psychosocial challenges as its earliest symptoms. Hand muscle issues such as grip weakness and myotonia can exacerbate these learning disabilities.
In children with Becker muscular dystrophy, learning disabilities are also slightly more common than in the general population, although intellectual function generally remains normal with this type. Some people with limb-girdle muscular dystrophy also develop learning disabilities.
Direct links between MD and brain chemistry
The same mutations that cause muscle weakness may also interfere with normal brain function. Proteins that are faulty in certain MD patients also have important functions in the brain.
Structural proteins regulate many cell-to-cell interactions that are vital for normal brain function. If these are not working as they should, it may mean that different neural networks do not communicate properly in brain regions that support verbal memory and executive function. This can lead to problems with these areas of learning and development.
Secondary educational obstacles
MD’s cognitive problems can also impair a person’s ability to get through a school day in a way that supports effective learning. For example:
- Your child might feel more fatigue, discomfort, and pain as the day progresses, meaning that tasks like handwriting, carrying books from class to class in a backpack, and moving across campus can be challenging.
- Your child may have to regularly miss school for medical appointments, surgeries, rehabilitation, and emergency hospitalizations.
- Reduced dexterity and hand strength might make handwriting notes hard. This may lead to unfinished notes or skipping test items if a school hasn’t provided appropriate accommodations.
- Nonaccessible classrooms, standard lockers, heavy doors, or long hallways might all present physical barriers to a standard education.
Signs of a learning disability
Learning disabilities look different from child to child, and many will struggle with reading, writing, or math at various points on their educational journey. However, children with learning disabilities will usually have several signs that do not get better over time.
These may include:
- difficulties with reading
- writing challenges
- problems with math
- memory issues
- struggles with paying attention
- issues with organization
- problems with telling the time
- clumsiness
A child with a learning disability also may exhibit one or more of the following:
- acting without considering the outcomes
- regularly acting out in social situations or at school
- challenges when talking out loud, expressing thoughts, or saying a particular word
- speaking as a younger child would, in simple phrases, or leaving out words in sentences
- difficulties handling schedule changes or different situations
- difficulties understanding certain concepts or words
Only a licensed professional can diagnose a learning disability. Some experts believe that children with DMD commonly have ADHD, difficulties processing spoken language, and difficulties in social interaction (especially in boys), which forms part of a controversial “Duchenne profile.”
When and how should a child be evaluated?
At their first diagnosis of MD, children with MD should undergo neuropsychological evaluation with a developmental or pediatric neuropsychologist to determine whether they have learning disabilities.
You may want to request a discussion with the school or your child’s healthcare team if you notice one or more of the following:
- difficulty learning new skills
- falling behind despite appropriate instruction
- language delays
- declining grades
- attention issues
- expressing an intent to avoid school or showing frustration that interferes with learning
Outside of school or clinical evaluations, teachers and caregivers are usually the first to notice when a student is struggling, either mentally, developmentally, or socially.
They can communicate with parents or guardians to recommend that tests be performed. They can also help determine the level of support that may be necessary, as well as a child’s eligibility under federal law for special educational support.
An evaluation for learning disability might include the following:
- a medical exam, including a neurological exam
- a review of the child’s social, school, and developmental performance
- discussions around family history
- psychological and academic testing
How can schools support students with MD?
While there is no cure for specific learning disorders or MD, many strategies can help students improve their math, reading, and writing skills and navigate the learning environment.
A learning specialist can help determine the most effective strategies for a particular student. This may include:
- using repetition or memorization
- using a picture to illustrate a word
- learning to convert one sort of problem into another format, such as changing a math problem into a word problem, or vice versa
- applying multimodal learning, in which students use their other senses (such as touch) to support the learning process
Classroom accommodations for MD
By making adaptations in classrooms and testing environments, teachers can prepare children with MD and learning disabilities for success. Different children will need different school accommodations, so it’s important to discuss these with a teacher or examiner and work out which may be suitable.
Accommodations can include (but are not limited to) the following:
- extended time (at least 1.5 or two times longer) and a quiet room to finish tests
- extra time to get to and from classes
- assistive technology, like the ability to record classes or speech-to-text capabilities
- a supportive chair
- an extra tablet and books for home to prevent unnecessary carrying back and forth
- shorter homework assignments when the child demonstrates they have the knowledge required
504 plans vs individualized educational plans (IEPs): What’s the difference?
Depending on a child’s needs, a learning specialist may recommend a 504 plan or an IEP for MD. Children with learning disabilities may also benefit from extra tutoring.
A 504 plan means that a child learns the same curriculum as their classmates, but they have accommodations (like those above) to go about it in a way that better supports their learning disability.
An IEP, on the other hand, is part of special education services. Your child may not necessarily receive education in a different classroom, but they will have an individualized curriculum to support self-advocacy, motivation, and academic progress.
Not all children with learning disabilities and MD will need an IEP, but if you notice that their signs are getting worse, you can request a new evaluation.
Learning support for MD at home
Education does not stop at the school gates, especially when you’re navigating DMD-related MD. You can support a child at home with the following approaches:
- Establish and enforce a routine: A consistent, low-stress daily schedule can help you manage issues with executive function, delayed attention, or steroid-related mood changes. You can also have advance warnings in place ahead of activity changes to prevent friction.
- Collaborate with the school staff and care team: Share medical guidelines and recommendations with teachers, school psychologists, and guidance counselors. It can also help to connect educators with resources to help them teach classmates about DMD to reduce bullying and improve connection.
- Use assistive technologies: When your child is learning at home, use the same technologies they use at school, like speech-to-text dictation and text-to-speech readers. Visual aids and chunked information (data that is broken into smaller parts) can help support children with working-verbal-memory issues.
- Build a homework schedule around their needs: Structure learning tasks around energy levels, and be sure to incorporate rest breaks. Keep physical written work to a minimum.
- Support the child’s confidence and independence: Involving the child in their own care decisions and goal-setting can help them foster self-advocacy and build their self-esteem. You can also align educational strategies with their personal interests, which can prepare them for higher education, future employment, and independent living during their transition into adulthood.
The post Learning disabilities and muscular dystrophy appeared first on Muscular Dystrophy News.