All issues > Volume 30(10); 1987

Original Article

J Korean Pediatr Soc. 1987;30(10):1078-1091. Published online October 31, 1987.

A Clinical Assessment of Children with Learning Disables.

Cang Jun Coe¹, Young Hyuk Lee¹, Jung Keun Kim¹, In Suck Ryu¹

¹Department of Pediatrics, Yonsei University College of Medicine, Institute of Handicapped. Children, Seoul, Korea

Abstract

Clinical investigation and assessment has been performed on 201 children with various learning disables, who are studying at special classes from 6 different school in Seoul. By this clinical study including medical examination following results were obtained. 1) Their age ranged from 7 to 13 year and male was dominant in number rating 1.3:1. 2) Their intelligence has been assessed by Korean-WISC test, and the score was various ranging 120 to under 45. The ones with K-WISC score over 100 were 38 children (18.9%), children who had score between 70 to 99 were 136 (67.6%), children between 50 to 69 were 17 (8.5%) and children whose score under 50 were 10 (5.0%). By medical investigation, 79 children (39.3%) manifested various medical problems including psychiatric or psychologic as well as behavioral problems. They are consist of 7 cases of hemiparesis, 16 cases of motor coordination defect or ataxic problems, 4 cases of microcephaly, a case of Down syndrome, tuberous sclerosis, Aarskog’s syndrome and one case manifested poor vision due to glaucoma, one case had hearing defect. Children with emotional problem were consist of psychiatric problem, psychologic problem as well as conductive disorders. 3 children manifested autistic behavior and bizarre social repsonse, 6 children manifested depressive response, 2 children phobic reaction and one child often experienced visual hallucination, and these children requires psychiatric investigation as well as treatment. 4 children who manifested excessive aggressive behavior, and another 6 children manifested habitual stealing, 5 children manifested night wetting and 2 children had tic. Those children who requires psychiatric or psychologic aid were 14.9% among 201 children with learning disables. By this study it is emphasized that medical investigation is one of the important part of assessment of these children with learning disables. 3) Children with hypophasia and dysarticulation were 29 cases (14.4%) and one of them had hearing defect. 4) The most of children manifested defect in visual motor integration (VMI) test, the one whose VMI age was delayed over 24 months from their chronological age were 84 cases. The VMI ability was corelated to K-WISC score and higher the K-WISC score, usually their VMI score was higher as well, representing Y = -0.93 X +109.93 (r=-0.72, p< 0.0001). 5) Most of them had some degree of dyscalculia, 62 cases manifested severe degree of dyscalculia or acalcuia. 6) According to Conner’s test, children with attention problem were 26 and children with attention deficit disorder with hyperactivity were 88 cases. Most of children were distractable, hyperactive and had short attention span. 7) By attention sustentation test, their attention sustentation ability was poor than that of normal children. 8) The social adaptation abilities of these children manifested various abilities. Most of the children whose KWSC score was under 70 showes low social adaptiation abilities in various degree. Children whose IQ between 70 to 90 manifested average social adaptation abilities compare to his or her age. Children whose IQ over 90 showes various abilities, higher, lower or average. Children whose IQ over 100, mostly manifested excellent social adaptation ability. Social adaptation ability score (manifested by age) of these children was corelated to their intelli- gence status, representing Y = -0.92 X + 107.31 (r=-0.70, p< 0.0001). 9) Dictation test has been performed with simple 20 phrases, and their score is not corelated to their intelligence. By this test it is evident that dyslexia is not corelated to IQ but influenced various defect. As there was no measurable method to estimate the degree of dyslexia as well as dyscalcuia, it was difficult to assess the children of their learning status. To solve this problems, measurable method should be design for better assessment of each grade or age. 10) As these children was having problem in reading and writing as well as calculation, these children requires special educational aid material for learning or wiritng as well as other subject such as moral education, science as well as sociology, etc. 11) Many children with learning disables were supposed to experienced psychological insult such as failure, poor self image due to learning disorder, poor human relationship, psychological support and aid is strongly recommanded for their future, as some of them may manifested antisocial behavior when they become an adult. As education of children with learning disables is not the merely educational problem, but also problem of sociology, psychologyl, medical science and social worker, cooperative research as well as co-work is remained as one of the social problem.

Keywords :Clinical Assessment