Introduction

In this, the fourth episode of 'A Gentle World from the Perspective of Children with Developmental Disabilities,' I will explain about children with learning disabilities/specific learning disorders (hereafter, "LD/SLD") and the world which surrounds them. In this series, I will focus on what adults can do to assist children with developmental disorder tendencies. Such disorders are associated with chronic aberrant brain development. Therefore, it is essential for them to find a way to get along well with the environmental factors surrounding them, including interpersonal relationships with adults, as opposed to making attempts to cure their disabilities. Simply being aware of the categories of their disabilities is different from thinking about what is best for them from their perspective. We should understand their behavior patterns and feelings, considering their respective characteristics. In this episode, I will discuss how we can understand and help children with LD/SLD tendencies, based on my research studies and school counseling experiences.

LD/SLD characteristics and secondary symptoms

The American Psychiatric Association (APA) now uses the term Specific Learning Disorder (SLD) in DSM-5 and DSM-5-TR published in 2013 and 2022, respectively. A person with specific learning disorders experiences difficulties in acquiring basic academic skills, but this is not due to any intellectual disability. The diagnostic criteria for specific learning disorders include difficulties in reading (in reading characters), writing (in writing characters), and math (in calculation and mathematical reasoning). It should be noted that these disorders are not due to intellectual deficits. For example, a person may demonstrate adequate intellectual ability, typically measured by IQ, but struggle significantly in one or more areas such as reading, writing, or math. I will show more detailed diagnostic criteria for SLD as follows:

Difficulties in reading

• Reading slowly, needing to process each word or hiragana character individually
• Difficulty in reading sentences separated by clusters of meaning
• Difficulty understanding the meaning of what is read

Difficulties in writing

• Mistaking similar characters
• Illegible handwriting (wrong pairing of radicals in kanji characters)
• Difficulty in accurately expressing one's own thoughts in writing

Difficulties in mathematics

• Difficulty understanding number-related concepts
• Difficulty making simple calculations
• Difficulty solving math problems using mathematical reasoning

As previously explained, children with specific disorders may develop secondary symptoms if they are not provided with an appropriate environment, including interpersonal relationships. Secondary symptoms can be roughly classified into 'secondary problems' and 'secondary disorders.' In the case of children with LD/SLD, they are more likely to experience secondary problems related to mental health, such as depression, lack of motivation, non-attendance at school, and social withdrawal. It is a matter of internalizing problems in which their energy is directed inward, rather than externalizing problems in which their energy is directed outward, indicating that they confront serious issues that are rarely visible.

In the following section, I will introduce you to Misa-chan, a child with LD/SLD. This will help us to understand the experiences of children with LD/SLD and prevent the development of secondary comorbidities.

A child who cannot memorize kanji

Misa-chan is a sixth-grade girl who has been having trouble with kanji since she started elementary school. During class, she is able to listen to her teachers and friends attentively and express her opinions clearly. At home, she works diligently on her homework with her parents. However, she has great difficulty in mastering kanji characters.

"I can't do it, no matter how hard I try" - Misa's voice

"I'm bad at writing. During class, my classmates can quickly take notes from the blackboard or textbook, but I find it difficult. I often get so focused on trying to figure out the kanji that I end up forgetting the sentence that I was trying to write. People tell me that I just need to copy down what I see, but I find that difficult. I have trouble memorizing kanji characters, so I have to carefully write out each stroke while comparing it to the blackboard or textbook.

Apart from simple characters that I have written numerous times, I write down kanji with a vague image, so, I sometimes miss one stroke or write slightly different but similar radicals in kanji. I like reading books, and can read kanji characters. But I just cannot write them down. When taking notes or writing sentences, it takes too much time for me to write kanji characters, and I feel exhausted when I finish. I also cannot get the shape of the kanji characters right, and my characters often overflow. If I try to speed up, I end up using hiragana instead, plus my writing gets messy, so my teacher reprimands me. No matter how hard I try, I can't seem to get it right. I hate myself for that, and I don't know what to do."

"Why only kanji?" - Teacher's voice

"Misa-chan is a conscientious student who listens attentively in class and works diligently on her assignments, although she requires more time to complete tasks than her peers. She is calm and seldom quarrels with her friends. She appears to have no concerns. However, strangely, she cannot write kanji when she takes a test, despite practicing writing the characters with her parents the day before. Her understanding is satisfactory and she consistently submits her homework assignments on time.

Another thing I am worried about is that she seems to struggle with taking notes and jotting down her thoughts, which often takes her a long time. She frequently makes errors, either by omitting radicals or writing the wrong ones. I understand she is not good at writing, but this is something she cannot do without. When I provide her with individual guidance sitting next to her, she will somehow manage to write the characters correctly. However, it is not feasible for me to give her such personal attention in every class, and that is a major cause of concern for me."

"I don't know what to do for her" - Parent's voice

"My daughter puts in a lot of effort with her studies. As soon as she comes home, she starts doing her homework. I often assist her in studying kanji because her teacher has pointed out her inadequate skills in writing kanji. Strangely, even though she studies and memorizes kanji the day before a test, she cannot write them during the test. Initially, I thought her memory capacity was below standard, but she can remember past events and other subjects quite well.

Therefore, she must have good memory retention. My daughter is not lazy. She has repeatedly tried hard to improve her kanji writing skills but has failed. It is perplexing for me to see her disappointment. Recently, she often says, "I'm useless; I can't change things anyway." I'm very worried about her, but I don't know what to do for her."

The difficulty of not being understood

Misa-chan experiences difficulty in learning academic skills despite not having any intellectual deficit. This situation indicates a serious issue. As her problem is often difficult to be noticed by those around her (Ito, Tsuchida, & Kawasaki, 2001), it can become a psychological burden when people urge her to try harder and harder (Torii, 2014).

Consequently, she may become depressed due to her perceived inability. If this situation persists, she may develop secondary symptoms like internalizing problems and learned helplessness where motivation is lost (Miller & Seligman, 1975).

Ultimately, she may feel exhausted and demotivated as her peers easily achieve tasks that she struggles with. Unfortunately, only a small number of people are able to understand the pain she is going through, and this can make it even more challenging for her. In addition, the problem lies in the fact that only a few adults fully understand this situation.

These children struggle to acquire certain academic skills no matter how hard they try, despite the absence of any intellectual deficit. We adults should take this more seriously and think about what we can do for such children and how we can provide empathy and support, as they might feel fear and loneliness facing such incomprehensible difficulties alone.

References:

• American Psychiatric Association. (2014). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). (supervised by Saburo Takahashi, Yutaka Ono; translated by Toshiyuki Someya, Shigenobu Kanba, Norio Ozaki, Masaru Mimura, & Toshiya Murai). Tokyo: Igaku-Shoin Ltd. (American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. DSM-5 (5th ed.))
• American Psychiatric Association. (2023). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). (supervised by Saburo Takahashi, Yutaka Ono; translated by Toshiyuki Someya, Shigenobu Kanba, Norio Ozaki, Masaru Mimura, Toshiya Murai, & Tomohiro Nakao). Tokyo: Igaku-Shoin Ltd. (American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders. DSM-5-TR (5th ed Text Revision))
• Masako Ito, Reiko Tsuchida, & Chisato Kawasaki. (2001). "Research on the difficulty of teaching young children from teachers' standpoint associated with neurological/neuropsychological backgrounds". Psychiatria et Neurologia Paediatrica Japonica. 41(2), 157-168.
• Miller,W.R., & Seligman,M.E. (1975). "Depression and learned helplessness in man". Journal of abnormal psychology. 84(3), 228-238.
• Naomi Sunami. (2022). Interpersonal interactions that nurture a sense of belonging and self-esteem among children with developmental disorder tendencies. Tottori: Imai Publication.
• Miyuki Torii. (2014). Understanding Children with LD. (extracted from "The Basics of Special Needs Education" by Masayoshi Yoshida & Miyuki Torii). Tokyo: Foundation for the Promotion of The Open University of Japan. 1st ed. 2011. 3rd ed. pp.130-142.
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