Related Disorders of a Learning Disability: What You Should Know

Thoughtful young womanIf you know that you or a family member has Learning Disabilities (LD) it is important to know approximately 50 percent of individuals with LD will also have one or more “related disorders."

There is a continuum of neurologically based disorders that are frequently found together. The basic concept is that if something impacts on the developing brain, resulting in an area or system being “wired differently,” it is possible that other areas might be involved as well.

These related disorders are referred to as “comorbid conditions.” If you or a family member has LD, it is important that the professionals working with you explore other problems that may be present so that they, too, can be addressed.

These comorbid conditions include:

  • Other problems primarily involving the cortex of the brain;
  • Attention-Deficit/Hyperactivity Disorder;
  • Specific difficulties with regulating emotions;
  • Tic Disorders;
  • (Possibly, Bipolar Disorders)

Before discussing each of these possible comorbid conditions, it will be important to explain how to distinguish between an emotional problem that might result in behaviors that look like these neurologically-based problems and true neurologically-based problems. If the problem (e.g., anxiety, depression,) is the result of emotional stress and emotional problems, they will begin at a certain time (e.g., “only began in third grade”) and/or will occur only in certain situations (e.g., only when asked to read aloud). If the problem is neurologically-based it will have been apparent since an early age and will be noted in most/all situations; that is, they are chronic and pervasive.

Cortically-Based Problems

People with LD may also have a Language Disability. He or she will have difficulty quickly processing what is heard, often not being able to fully understand or to keep up. Others may have no difficulty speaking when he or she initiates the conversation, but have significant difficulty finding the right words and organizing thoughts when asked to respond to a question or comment. Thus, language disabilities might result in receptive and/or expressive language problems.

Another possible cortically-based problem relates to a Motor Coordination Disorder (often referred to as a “Sensory Integration Disorder”). One might have difficulty coordinating teams of small muscles (fine motor skills), resulting in poor handwriting and possibly in difficult with buttoning, zipping, or tying. Others might have problems coordinating teams of large muscles (gross motor skills), resulting in being clumsy and running with poor coordination. Some might have difficulty coordinating eye-hand activities (e.g., coloring and staying within the line) or knowing where they are in space (e.g., bumping into things, knocking things over). Another aspect of motor problems might relate to maintaining balance, resulting in difficulty riding a bike or in quickly going down stairs. Finally, some with motor problems might be very sensitive to touch. They don’t like being touched and complain about how their clothes feel against their skin.

In addition to possible language or motor difficulties, some individuals with LD might have problems with such higher level tasks as organization and executive function. He or she will have problems organizing materials, losing, forgetting, or misplacing things. Or, the problems might relate to organizing ideas when speaking or when writing. Executive function problems relate to analyzing tasks, then deciding how to address these tasks, and finally knowing how to carrying them out in a timely way.

Attention-Deficit/Hyperactivity Disorder (ADHD). About 50 percent of individuals with LD will have ADHD. This problem is characterized by a chronic and pervasive history of hyperactivity, inattention, and/or impulsivity. The inattention might relate to being distracted by what is seen or heard. It is commonly seen as a problem with organization and difficulty with executive function.

Regulation of Emotional Problems

It is not uncommon for adults or children with LD to struggle with anxiety, depression, and/or with anger control as a result of the frustrations and failures experienced. These emotional problems usually start at a certain time and relate to specific circumstances/stresses and are thought of as secondary emotional problems.

But, for 50 percent or more of individuals with LD, the problems with regulating their emotions are not related to a situation, they are neurologically-based. These problems have a chronic history, often beginning in early childhood, and are pervasive, occurring at home, in school, with friends, and during any month. Often, there is a family history of similar problems.

Anxiety Disorders

These disorders might be related to specific themes such as separation, social interactions, performance, specific objects, or specific places. Or, the anxiety disorder might be generalized to most aspects of life. If the level of anxiety becomes too great, the child or adult will experience a panic attack with an increased heart rate, breathing rate, sweating and feelings of apprehension.

Depression

Behaviors suggesting depression might include feeling depressed, an irritable mood, decreased interest or loss of pleasure in many activities, sleep disturbances, decreased ability to concentrate, indecisiveness, agitation, slowness of thinking, fatigue, feelings of worthlessness and, inappropriate anger. Suicidal thoughts or thoughts of death might occur.

Anger Control

This problem, also referred to as an “Intermittent Explosive Disorder,” results in angry outburst that go beyond the typical tantrum. They are real melt downs. The child or adult will quickly lose his/her temper, often so fast that it is not clear what set it off. This rage will last for five to ten minutes or up to an hour. During this rage, he or she will be threatening, often screaming, cursing, hitting, and throwing. These behaviors appear to be irrational and the person cannot be reasoned with. This episode ends almost as quickly as it begins. Once over, the person may feel sorry for what was done and have difficulty explaining the behaviors.

Obsessive-Compulsive Disorder

These problems often begin in early childhood. Some might also have difficulty with obsessive thoughts. Others might have the need to do compulsive behaviors. Common compulsive problems might include the need to count or repeat behaviors, the need to check what was done over and over, the need to collect or hoard objects, the need to arrange and organize things, the need to clean and wash, or the need to bite nails or cuticles, pick at sores, or twirl/pull out hair.

Tic Disorders

Some children and adults may have difficulty regulating certain motor functions. They experience contractions of clusters of muscles causing motor tics. Others may experience the need to say certain sounds or words, called oral tics. These tics may come and go and change in form. If both motor and vocal tics are present, the problem is often called Tourette’s Disorder.

Bipolar Disorder

It is not clear if this disorder should be seen as a comorbid disorder. It may be present if someone has LD. The primary behavioral pattern relates to mood swings. These swings might be from depression to a state of super happy, referred to as manic behavior. The mind is racing and full of thoughts. It is difficult to stop talking or acting or to relax. Behavior is driven and may appear to be inappropriate. Another possible mood swing is from calm to irritability or rage. As with the other related disorders, these behaviors show a chronic and pervasive history and there is often a family history.

Related Neurologically-Based Disorders

  • Cortically-Based Disorders
    • Learning Disabilities
    • Language Disabilities
    • Motor Coordination Disorder
    • Organization/Executive Function Disorders
  • Attention-Deficit/Hyperactivity Disorder
  • Regulatory Disorders
    • Anxiety Disorders
    • Depression
    • Anger Control Problems
    • Obsessive-Compulsive Disorder
  • Tic Disorders
  • Bipolar Disorder

What to do?

If you or your child has a LD and you suspect other cortical problems, such as a Language Disability, Motor Coordination Disorder, or problems with organization and executive function, speak to your child’s principal. You should request that these problems be considered and appropriate evaluations be done. Should they be confirmed, special interventions will be needed; for example, special education, speech-language, occupational therapy services. Specific accommodations will also be helpful.

If ADHD is suspected, discuss this possibility with the family physician. He or she should be able to diagnose and treat this disorder. If not, a referral to a general psychiatrist or a child and adolescent psychiatrist may be needed.

If any of the emotional regulatory problems or Bipolar Disorder is suspected, seek a consultation with a mental health professional. If medication might be needed, this evaluation might be best done by a general psychiatrist (for adults) or a child and adolescent psychiatrist (for children and adolescents) to clarify the diagnosis and to recommend treatment.

What not to do?

Do not believe that LD stands alone. Consider all of these possible related disorders. If you suspect that one or more might be present, seek a professional to confirm the diagnosis and to help with planning the necessary interventions. Start with your child’s primary care doctor and then with appropriate referrals.

Author: Larry Silver, MD

Related Resources:

Learning to Achieve is a suite of resources designed to build teacher effectiveness in providing instruction for adults with learning disabilities (LD). It includes an integrated set of research-based resources and professional development materials available for self-study or trainer-led events.  In a free, self-paced module, participants learn about the underlying neurobiology of learning disabilities. It can be accessed at  https://lincs.ed.gov/programs/learningtoachieve/materials.html

Comments

  1. Hello
    I liked reading this outline of disorders regarding LD and Mental Diagnosis. As a mother of a 9 year old with Adhd, ODD, OCD and Dyslexia I am just on the look out for information that will help me recognize key behaviors. As our family history has both Adhd, Bipolar and anxiety issues.. I often wonder if one turns into the other. I am also Finding the lack of parental support for this type of Diagnosis in Skagit county. Autism issues seems to be well supported . Those of us who have children with Adhd and ODD know how exausting it is to help these kids once meds are worn off.. There isn’t respite care that I know of for these parents. I welcome information regarding parent groups,classes or group therapy sessions for kids learning about social ques and how to react.

    • MY NAME IS WENDY I HAVE THE SAME CHALLANGES . YOU ARE WELCOME TO CALL ME IM NOT GOOD ON A COMPUTOR AND WHERE WE LIVE WE DO NOT HAVE GOOD INTERNET CALL ME OR TEX ME SO I KNOW WHO YOU ARE I THINK I CAN HELP YOU WIH WHAT TO LOOK FOR AND UNDERSTAND WHAT HE IS THINKING AND HOW THINGS MAKE HIM FILL YOU HANG IN THERE AND JUST KEEP LOVING HIM HE NEEDS TO KNOW THAT HE IS OK

  2. My daughter is 40 years old and she is so good and so bad with her outburst and so mean to her father. I can not leave the house when I come home she is so awful I can’t hardly deal with this any more. Her father and I can not go out together or even speak to each other. I m in mercer county no I need help! Please send a name of a dr for her. I’m 68 and I think I can’t live like this anymore!!!!

    • Charlotte Ischy says:

      Mary,
      I understand your pain. My former friend has a daughter 29 years old who has LD and violent public melt downs. The mom just brushes it off and will even laugh! She then says that her daughter is pms’ing. The daughter is clearly extremely angry and has emotional problems as well as physical deformities, her fingers are in a twisted position, feet turned inward, and she is cross-eyed along with a huge forehead, extra tiny mouth, smooth philtrum (the groove between the upper lip and nose), and she has tiny ears that protrude, all the facial characteristics common to fetal alcohol syndrome (which is something else the mom is in denial about even though everyone knows she drank heavy during her pregnancy). I stopped going anywhere in public with them because her daughter is consonantly by her side acting like an out of control two year old who apparently is on her period every day of the year. I commend you for being aware and not in denial like my former friend. I pray you can find some help.

  3. Interesting article! I never knew that LDs are associated with so many related mental disorders. In case, when one or more such disorders are present, the situation becomes even more complex and the first thing we need to do is to approach a therapist for accurate diagnosis of all the disorders present. In the absence of proper diagnosis, the Learning Difficulties and Disabilities (LDDs) of a child may lead to major career and life setbacks.

  4. mandhirsingh says:

    My grand son age approx 9years studies inclass 3rd he has learing and writing difficulty. Suggest me how I can help him.

  5. Janice Rivera says:

    MY NAME IS JANICE RIVERA FROM ROCHESTER NY AND I HAVE LEARNING DISABILITY AND DEPRESSION
    IM EXPERIENCING MOST FAILURES IN MY LIFE.IM DEPRESSED

    • sandra jennings says:

      I feel for you my son has depression to and just wants to give up. I believe we all have gifts, and purpose in life. Some of us it’s not as easy as others. Maybe your gift is just caring and showing others a little kindness and love. May not seem much but it’s a bigger gift then someone making lots of money and not sharing or caring for others.I wish I knew how to help but just know I have you in my prayers Janice ,and to God I’m sure he thinks your amazing. Just please don’t give up, and find that happiness that you deserve.

  6. I need adult help with education so that i can further my education

  7. Carly Bernard says:

    My stepdaughter was diagnosed with ADHD at age 8. She came into my life when she was 14 and I perceived her as immature for her age. She graduated high school (with some struggle and many successes) and now is attending a technical school (with some struggle) to become a veterinarian tech assistant. She is doing well. She also works at Goodwill, but only gets to work a couple of weekend days per month.

    The issue that I have is that I have a hard time communicating with her. Sometimes I feel like I am mean to her because she often forgets or just doesn’t complete what she was asked to do, whether avoidance or she truly forgets. I am not sure if my expectations are unrealistic when it comes to responsibility. What is too much? What should I be doing to be more encouraging and not so demanding? I am frustrated.

  8. My son is 17yrs old he just informed me that he suffers from depression as a result of his LD He feels he’s a failure & lack self esteem because he’s not progressing at the rate of his peers in the neighborhood & at school. He has always struggle in school with me having to pay for a tutor practically up to high school.

    He recently took his ACT test we are awaiting the results but he feels that he tanked. Because of his constant failure at things his attitude & mind set is that of defeat before he even sets out to do anything. It broke my heart to hear my son say he feels he’s worthless base on his LD. He informed me that he is depress & has a lot of anxiety now that he’s about to graduate from high school & he has no idea what he wants to do or if he can even achieve what he likes to do.

    I’m currently looking to get him help from a psychologist that specializes in LD & depression. I believe that God created all his people for a specific purpose & I have to pray & ask God what that is for him. I WILL NOT give up on my son regardless of his challenges. We will work together to find his path in life in terms of his career path.

  9. sandra jennings says:

    I agree with you and pray for you and your son. Mine is 18 and is lost and depressed. I’m like you I tell him he is not alone and sells himself short, and we will work this out.

Speak Your Mind

*