History

One-hundred years ago Morgan (1896) speculated that the inability of a bright 14-year-old boy to read was caused by defective development of the left angular gyrus, a condition he called congenital world blindness.  Attention to behavioral and achievement problems of children was heightened in the aftermath of influenza that swept North America and Europe between 1917 and 1920. After onset of the disease, children were said to develop impaired attention and memory and to lack impulse control. Neurological explanations for reading problems were further advanced by Hinshelwood (1917), who believed congenital word blindness to be a rare condition. Early in the century there was a clear dichotomy between genetic and acquired disorders related to the brain.

Orton (1937) believed that disabilities are related to disorders of cerebral dominance. According to Orton, if cerebral dominance is fully established, or lateralized, then the dominant cerebral hemisphere controls language functions. In "mixed" dominance, the subdominant hemisphere may exert a disturbing influence on reading and writing, which he thought was revealed in reversals of words and mirror writing found in young children and older children with mild to severe reading problems. Finding a preponderance of some family members to share reading, writing, and arithmetic disorders led some to conclude that problems are sometimes neurologically based and genetically caused (Hallgren, 1950; Critchley, 1970). Dyslexia became the preferred label for this group.
 In 1947, Strauss and Lehtinen published their classic book, Psychopathology and Education of the Brain Injured Child, regarded by many as the foundation of the field of learning disabilities that would emerge two decades later. Strauss had worked with brain-injured adults in Germany, and after emigration to the United States; he collaborated with Lehtinen to study institutionalized children. Strauss and Lehtinen proposed that brain injury caused characteristic behavioral, perceptual, and thinking disorders that they identified as abnormal responses to environmental stimuli, distractibility, perseveration, higher levels of motor activity, hyperactivity, disorganized behavior, perceptual disturbances, and motor problems. The diagnosis became so popular that these characteristics became known as the "Strauss Syndrome."

Lehtinen developed educational plans for the brain-injured (Strauss Syndrome). These included reduction of stimuli, carefully regulated motor activities in learning, judicious use of color to stimulate visual perception, structured concrete-manipulative activities, and a very structured classroom environment, methods that had previously been used to retrain brain-injured adults. In the 1960s, Cruickshank (1967) popularized these same methods in materials that influenced both teacher preparation and school programs, and a variety of therapies and programs to strengthen underlying perceptual-motor skills were quite popular. A different approach to instruction for dyslexic children was stimulated by the Orton-Gilingham method, which primarily focused on reading.
 Kirk (1963) proposed the term learning disabilities to the group of parents who organized the Association for Children with Learning Disabilities (ACLD). Clements (1966) promoted minimal brain dysfunction to distinguish between children with serious neuropathology and the minimally affected. One of the early texts on learning disabilities by Johnson and Myklebust (1967) used the term psychoneurological learning disabilities. Chalfant and Scheffelin (1969) used central processing dysfunction to refer to many types of learning disorders relating to a range of skills they thought were important in the neurophysiological use of information. While different professions refer to similar conditions with different names, the term learning disabilities or specific learning disability gained widespread acceptance due to federal legislation (Federal Register, 1977), but there have been two large groups reported in the research literature: those presumed to have brain damage and those to have a genetic etiology.

The first widespread research was conducted in institutions, where subjects were easy to obtain and study.  Those with "endogenous" and "exogenous" conditions were examined, although many of these subjects had behavioral problems, subaverage intelligence, and other problems that caused them to be institutionalized; but it was research with this group that was the foundation for the future field of learning disabilities. Subjects with brain damage due to pre-, peri-, and post-natal diseases and complications presented a variety of problems that came to the attention of researchers: head injuries, seizures, and other neurological conditions. As the research was transferred to the school population, the label of "brain damage" became a defining characteristic, although the presenting problems were much less severe in kind and degree than those observed in institutions.

Gesell and Amatruda (1947) used the term minimal cerebral injury to refer to infants with various developmental problems. Gesell's fame as an expert in child development lent credence to the use of the modifier "minimal." Others gradually applied the term to children who did not have severe anomalies but who were believed, nonetheless, to have organic damage.  Recognizing that the terminology of brain damage was inappropriate, it was gradually de-emphasized over three decades with different terms to modify its meaning [i.e., Minimal Brain Injury (MBI), Minimal Brain Damage (MBD), Minimal Brain Dysfunction or Disorder (MBD), and Hyperkinetic or Hyperactivity Syndrome]. At the same time, the population of dyslexic children became separated, presumably owing their problems to genetic disorders quite apart from "brain damage." In effect, while there were undoubtedly many children with serious problems of learning and/or behavior, the great majority of children with dyslexia and ADD, as they are known today, are not the same population that was originally studied in the 1930s.

Contemporary Views of Learning Disabilities

From the 1960s until today no definition of learning disabilities has gained wide acceptance among professionals. All definitions of learning disabilities are vague, dwelling on what a learning disability is not rather than what it is (Levine, et al, 1993).  The field has expanded to include new conditions that use old terminology, attention deficit disorder (ADD) and/or attention deficit hyperactivity disorder (ADHD). Today there are several distinct groups of specific learning disabilities recognized by professionals, but only dyslexia and attention deficit disorder/hyperactivity disorder have been said to have sufficient validation to permit objective evaluation rather than clinical impression.

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