Specific Learning Disability Case Study

In presenting this Specific Learning Disability Case Study, teachers and parents can easily come to understand this special education eligibility category and the type of student who might qualify under the category. This case study is centered on a student who has been diagnosed with a specific learning disability (SLD).  Although the student was diagnosed with having a specific learning disability two years ago, the student has shown remarkable progress in recent months. With the progress he has made, his disability is almost unrecognizable. There are various elements that may have caused the lessened severity of his disability; however the discontinuation of seizure medication is hypothesized to be the main cause. In this case study, I will give an overview of the student’s family and educational background, the implications of having a specific learning disability, and the services and goals that are in place for this student.  

 

Background Information

This case study is centered on a second grade, male student named Sam. Currently Sam is a seven year-old student at a private school. Sam is an only child and lives with both his mother and father. The Caucasian family speaks predominantly English. Sam has not experienced any outstanding life circumstances such as divorce or death in the family, recent arrival to the country or incarceration of a family member. Sam’s mother in particular has taken a very proactive role in advocating for her son.

When Sam was only three years old he was diagnosed with epilepsy. The doctors described Sam as a boy who suffered from simple complex seizures. These types of seizures are much less intense than grand mal seizures, which usually include occurrences of major body spasms. Sam’s simple complex seizures would cause him to shift his eyes into a fixated stare for short periods of time. When Sam was diagnosed with epilepsy, he began taking the medication Carbatrol in order to control his simple complex seizures. When Sam grew to be six years old, his parents felt concerned by the development of involuntary tics. At this time, Sam began a regimen of Tenex in addition to Carbatrol in order to alleviate his tics. Sam’s parents also began to worry about his seemingly impulsive, inattentive, and obsessive-compulsive behaviors at home and at school. These behaviors appeared to crate learning impairments for Sam who received mainly NI (needs improvement) and some S (satisfactory) grades throughout kindergarten and first grade. After receiving a psycho-educational assessment, a neurological assessment, and a speech and language assessment, it was determined that Sam was eligible to receive special education services under the diagnosis of a specific learning disability.

After Sam completed first grade, his mother began to question her son’s educational placement. The family valued wanted for Sam to fully benefit from the special education services that a school (private or public) could offer him. With this in mind, Sam’s mother began to research her son’s disability and met with a specialist at a children’s hospital discuss her concerns. A doctor examined Sam and attested to the fact that his EEG results were abnormal. Typically abnormal EEG readings are related to seizure disorders; however the doctor suspected that the seizure disorder Sam developed at three years old no longer existed. The doctor advised Sam’s mother to wean her son off of Carbatrol and Tenex, which he had taken for the last four years. Sam discontinued the use of these medications. Since that time, Sam has shown unbelievable progress.

Educational Background

When Sam was in kindergarten, his teachers and his parents recognized that he had a difficult time staying on task. Although Sam struggled in kindergarten, his inattentiveness was not a grave concern until he reached the first grade.  At this time, Sam’s positive interactions with peers were strengths; however he struggled with articulation errors, reading, and concepts in Math such as understanding the ones and tens place values. Sam’s unfocused work habits and his inability to complete class assignments became a growing concern to both his teachers and his parents. Sam’s first grade teacher reported making the following modifications for Sam within the classroom: preferential seating, circulating around the room, use of visual aids, one-on-one or small group instruction, writing all instructions and assignments clearly on the board,  and varying materials.

Sam’s parents decided to have their son assessed for a learning disability and toward the end of first grade, Sam had been diagnoses with a specific learning disability. Because there were only three months of school left and because there was no resource or special education teacher at his private school, Sam completed first grade with out receiving further modifications. Despite their fears concerning Sam’s educational needs, Sam’s parents decided not to send him to a public school.

With an individual education plan in place, Sam currently began receiving modifications from his second grade teacher such as: preferential seating, highlighted directions on assignments and tests, oral testing, one-on-one or small group instruction, use of the testing room, and services from the resource and inclusion coordinator. Sam spent forty five minutes every day with the resource and inclusion coordinator in a separate classroom. Without medication and with these accommodations, Sam was successful academically and socially during his entire second grade year.

Sam is an enthusiastic boy who, in spite of his past difficulties with learning, demonstrates confidence in the classroom. He readily volunteers to assist his teachers, reads aloud in class, and writes answers on the board. Sam is kind to his classmates and is socially welcomed by his peers. Sam’s parents have said that at home, he listens, focuses, and communicates his feelings very well. These behaviors are relatively new. Sam’s mother described that only one short year ago Sam seemed emotionally and developmentally delayed. Although Sam currently demonstrates strengths in oral reading, enthusiasm, normal social and emotional development, and confidence, he continues to struggle with mathematics, reading comprehension, memorization, and calling out during class. Sam’s current teacher mentioned that Sam has made big improvements this year. He is no longer the self-conscious child who never participated or initiated activities and copied work from others. Sam’s grades have improved significantly as well, as he now earns G (good) and S (satisfactory) grades.

The Student’s Disability and IEP

Sam’s initial individual education plan (IEP) meeting took place several years ago. Prior to the IEP meeting, assessments were administered by a school psychologist from a public school district. Based on the assessment results, Sam was eligible for special education services as a student with a specific learning disability. Sam’s primary disability is his specific learning disability, which is accompanied by a secondary eligibility under the Other Health Impairment category. The text Best Practices in School Psychology V. explains; “The essential description of a specific learning disability is the presence of a weakness in basic psychological processes accompanied by academic failure” (Lichtenstein R., 2008, p. 680). These weaknesses can be very discouraging to parents. One online organization called the Matrix Parent Network and Resource Center, further explains that specific learning disabilities include a wide range of learning difficulties and children with specific learning disabilities make up the majority of children who are eligible for special education (Specific Learning Disabilities, 2008).  In facing Sam’s diagnosis, he and his family knew it was necessary to assess his need for related services in addition to special education. Related services such as speech and language services and occupational therapy services were discussed during the IEP meeting and determined as unnecessary for Sam to benefit from special education. The IEP team came to an agreement that Sam’s educational needs were not due to: social maladjustment, lack of instruction in math or reading, temporary physical disability, limited English, or environmental factors.

One fascinating element of this case study was the comorbidity of Sam’s specific learning disability and his epilepsy. After researching the prevalence of these two conditions existing together, I came across an article on the Learning Disability Association of America website which revealed some interesting facts. The article mentioned that about 40% of individuals with epilepsy develop learning disabilities. Of these individuals with learning disabilities, most are diagnosed with mental retardation, speech and language disorders and/or specific learning disabilities. The article continued to reveal that cognitive impairments can also be a side effect of the various anticonvulsant medications used to treat epilepsy. Anticonvulsant medications can sometimes cause learning difficulties, behavior changes, and impairments in memorization (Epilepsy and Learning Disabilities, 2008). This article confirmed the possibility that Sam’s epilepsy medications could have been the cause of his disability. Thankfully, now that Sam is off his medication, his learning difficulties, challenging behaviors, and inability to memorize and attend have been reduced to nearly nothing, and his seizures have not resurfaced.

At the time of assessment, Sam was six years old, taking his seizure medications, and displaying inattentive and impulsive behaviors. The professionals who assessed Sam each claimed that his epilepsy (and not his medications) had caused his learning disability. Prior to diagnosis, Sam had to undergo numerous assessments by numerous professionals. One article found on the Council for Learning Disabilities website helped me to recognized that, “Policy must continue to require multiple assessments to identify learning disabilities across domains and to document the severity of the disability to help inform decision making for appropriate services to meet the individual needs of students” (Elksnin L., et. al., 2001, pp.6-7). Interestingly, even though professionals did use multiple assessments to identify Sam with a specific learning disability, these multiple assessments did not uncover the mystery that his medication was linked to his learning difficulties. This fact emphasizes the necessity of extensive assessment and research.

During the first grade, Sam’s teachers described him as having a lack of confidence and low self-esteem. Possible reasons for these characteristics could be tied in to his specific learning disability. The National Center for Learning Disabilities website contained a relevant article that discussed the effects of learning disabilities on a student’s self-esteem. Learning disabilities not only cause struggles academically, but they also create frightening hurdles to positive self-esteem, and in turn contribute to a hard-to-break cycle of self-doubt, frustration and social failure (Self Esteem Fact Sheet, 2008). Fortunately, Sam had continued encouragement from family members and teachers, which helped him to work past his self-doubt and succeed in the second grade.  

Goals For the Student

Sam’s IEP contained two suggested goals for him to work on over the next year. The IEP contained a reading goal that specifically listed incremental objectives and a final objective that stated a target reading accuracy of 80%. A similar goal related to math stated that Sam would be able to work in incremental steps toward being able to calculate answers with 80% accuracy. Although the IEP only listed these two detailed goals, Sam’s teachers and his parents also had goals in mind for Sam. In general, Sam’s teachers were focused on developing his memorization abilities, reading comprehension, and written expression. Sam’s demeanor had never been mean or disruptive according to his parents and teachers; yet another goal Sam was to work on developing confidence in the classroom and participate in learning activities. Sam has gone beyond this goal and he even received an award for his enthusiasm at a school assembly. Sam continues to struggle in math, but his oral reading, writing and reading comprehension have improved within the past three months. Presently, Sam’s teacher categorizes him in the normal range when considering her class of twenty-two students. When tests are given orally, Sam’s scores greatly improve and recently Sam received 100% on a reading quiz that he was able to read entirely to himself.

Sam’s academic abilities have greatly improved since he discontinued the use of Carbatrol and Tenex; however he still receives special services on a daily basis. Because Sam attends a private school, there is not a special education program that is readily available. In the place of a special education program, his school has a resource room that is used by the school’s resource and inclusion coordinator. Sam visits the resource and inclusion coordinator with two other male students from his grade level every day for about forty-five minutes. This time is spent on strengthening reading and writing abilities. Sam also uses the resource room when he needs to have a test, quiz or assignment explained more thoroughly or read to him orally. At times, the inclusion coordinator will also come and work with Sam in the general education classroom.  The general education teacher allows Sam to take breaks during instruction to get up from his seat, use the bathroom, or get a drink of water whenever necessary. Sam is integrated into the general education classroom about 85% of the day, every day. Sam receives preferential seating and his teacher works with him during Math in a separate assistance group with other low-scoring students.

Conclusion

All students who qualify for special education services are likely to present with unique characteristics and life circumstances that make them difficult to compare with other students in special education. Sam’s experience with special education differs from that of some students who receive special education services in that he attends private school. Being a student at a private school, Sam does not receive services from a special education teacher; however he does receive services from a resource and inclusion coordinator. This benefits Sam in several ways. First, the aim of the inclusion coordinator is to help Sam eventually integrate himself back into the general education classroom full-time. Since Sam has shown tremendous improvement in recent months, it seems appropriate that he is working toward becoming re-integrated with his classmates 100% of the time. Sam’s parents are thrilled with the progress their son has made since they discontinued his medications, which seemed to have been instigating the symptoms of his learning disability. His mother now expresses hope that her son will soon be able to thrive in his learning environment without needing additional services.

Considering that this student, who suffered a seizure disorder at age three, now has almost no sign of a disability, is remarkable. Descriptions of Sam are given by his teachers and his parents, he seems like a completely different child than he was in years prior. Sam’s progress in reading has been remarkable, while his Math abilities remain fairly low. It is important for Sam to continue receiving special education services in the area of Mathematics. Sam is now successful in remaining attentive during class and he also maintains positive peer relationships. It is clear that Sam has made outstanding progress since having been diagnosed with a specific learning disability. Sam has received special services due to his learning disability, but it appears more likely that his progress was due to the discontinuation of his medication. Regardless, Sam is succeeding. It is important for all teachers and parents to keep in mind that with the correct balance of appropriate interventions in the right educational setting, children with specific learning disabilities can and should make progress over time and become academically successful.

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References

Elksnin L., Diane Pedrotty Bryant, Debi Gartland, et. al., (2001) Learning Disabilities Roundtable: Seeking Common Ground: Priority Issues. Council for Learning Disabilities: http://www.cldinternational.org/PDF/Legislation/PriorityRoundtable_CLD_Whitepaper.pdf

Lichtenstein R. (2008) Best Practices in School Psychology V. Bethesda, MD; National Association of School Psychologists.

Self Esteem Fact Sheet, 2008. National Center for Learning Disabilities: http://www.ncld.org/content/view/866/391/

Silver, Larry B. MD. (2006) Epilepsy and Learning Disabilities. Learning DisabilitiesAssociation of America: http://www.ldanatl.org/aboutld/professionals/epilepsy_ld.asp

Specific Learning Disabilities, 2008. Matrix parent network and resource center: http://www.matrixparents.org/pub/pdf/Learning%20Disabilties9.08.pdf

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