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Evaluation and Intervention Strategies in Children with Learning and Behaviour Disorders: An Experience from 333 Children from a Tertiary Referral Center Smita A. Desai (Ph.D) Sanjeev V. Kothare, MD, DCH, FAAP (USA) Referral Center: Drishti, Mumbai, India


Aims Part I: Evaluation – To study the prevalence of Learning Disorders (LD), Behavior Disorders (BD), Developmental Disorders (DD), Mental Retardation (MR), Emotional Disorders (ED), in 333 children aged 3-14 years. Part II: Intervention – To assess the effect of intervention in a subset of children with LD with average IQ.


Part I - Sampling Population: Urban children with learning and/or behavioural difficulties Size of sample: 333 children Age group: 3-14 years Sex Distribution: – Males: 242 – Females: 91


Part I - Procedure Individualised Assessment Plan: – Standardised diagnostic tests for the following areas: • Intelligence, Achievement, Information processing skills, Emotional and Behavioural Difficulties, Developmental functioning

– Observations – Parent Interview & checklists – Teacher Interviews & checklists


Part I - Measurement tools Some measurement tools used – Intelligence: WISC, SFB. – Achievement: WJ-R Psycho-educational battery, Schonell’s Diagnostic and Attainment Test, Curriculum Based Tests – Information Processing: BVMGT, MVPT, TAPS, RIPA, Aston Index – Developmental screening: DASI-II, VSMS, MDFG, EASIC – Pervasive Developmental Disorders: GARS, CARS, GADS – Emotional Disorders: CAT, SSCT, HSPQ, HTP, SAED, CBRS


Results - I Primary Diagnosis 5% 19%

LD 42%

BD DD MR ED

24% 10%

BD includes primarily ADHD DD includes Speech and Language impairments, Autism, and TBI


Comparing Prevalence Data 60%

US Govt. data

51%

50%

Sample

43%

40% 30% 21%

23% 19%

20% 11%

10% 10% 0%

8% 5%

4% LD

BD

DD

MR

ED

BD includes primarily ADHD DD includes Speech and Language impairments, Autism, and TBI US govt. data from Digest of Education Statistics, US govt.,2000 (age grp.6-21 yrs)


Results - II Secondary Diagnosis

9%

LD BD DD

30%

MR

57%

ED 2% 1% 1%

NA


Results - III Intelligence Levels 100%

Ave B. Ave

% sample

80% 60% 40% 20% 0%

LD

BD

DD

Disability Area

MR

ED


Results - IV Perinatal Encephalopathy 100% % Incidence

80%

76% 55%

73% 71%

66%

60% 40% 20% 0% LD

BD

DD

MR

Pathological Symptom

ED


Results - V Speech Delay 95%

100%

82%

% sam ple

80% 60%

35%

41% 29%

40% 20% 0% LD

BD

DD

MR

Disability area

ED


Results - VI Medical History 100% 63%

% sample

80% 60%

58%

52%

39%

35%

40% 20% 0% LD

BD

DD Disability area

MR

ED


Results - VII Concomitant Disabilities 100% 63%

% sample

80% 60%

64%

69%

40% 24%

40% 20% 0% LD

BD

DD Disability area

MR

ED


Results - VIII Grades Repeated 44%

50%

% sample

40%

32% 25%

30%

18%

20%

6%

10% 0% LD

BD

DD Disability area

MR

ED


Results - IX Gender Differences 27.6%

Male Female 72.7%


Part II - Methodology Sample – 24 children (age group: 9-14 yrs ; 16 males, 8 females) – LD with GIQ of 90 and above Areas of Intervention – Reading (word reading, comprehension) – Written language (spellings, composition, creative expression) Evaluation – Criterion referenced tests


Part II - Results Creative Expression

65%

Written Composition

72%

Spellings

78%

Comprehension

80%

Word Reading

83% 0%

20%

40%

60%

Performance (%)

80%

100%


Discussion & Conclusions Largest number of referrals for academic difficulties & speech delay (w\autism) Birth encephalopathy - implications for health care in developing countries Learning & Behavioral disorders underrecognised as pediatric difficulties Limited English Proficiency (LEP) - effect on Assessment and Intervention

Research on Intervention strategies for LD and BD - ICAP, 2002  

Evaluation and Intervention Strategies in Evaluation and Intervention Strategies in Children with Learning and Behaviour Disorders: Smita A...

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