Ch.1+additional+resources

History of the field of learning disabilities
This section provides more detailed information for Chapter 1 on the history of learning disabilities. Theories, concepts, and research findings that advanced the thinking within the field were generated by many individuals and stem from several disciplines. Each contribution added to and redirected earlier theories and, in turn, inspired further research and investigation. It is convenient to divide the history of learning disabilities into three periods. (See Figure 1.) Figure 1. Phases in the Development of the Learning Disabilities Field **1** **1800–1930**
 * **Foundation phase** (about 1900-1930). Marked by basic scientific investigations of brain function and dysfunction.
 * **Transition phase** (about 1930 – 1960). Research findings about brain dysfunction were applied to the clinical study of children with problems in learning, and professionals began to develop assessment and treatment methods for those children.
 * **Integration phase** (about 1960 – 1980). Characterized by the rapid growth of school programs for students with learning disabilities; the eclectic use of a variety of theories, assessment techniques, and teaching strategies; and the enactment of legislation designed to protect the rights of children and youth with disabilities.

Foundation Phase
Early Brain Research || **2** **1930–1960**

Transition Phase
Clinical Study of the Child || **3** **1960–1980**

Integration Phase
Implementation in the Schools ||

The Foundation Phase: Early Brain Research
The foundation phase, 1800–1939, was a period of basic scientific research on the functions and disorders of the brain. Many of the early brain researchers were physicians involved in investigating the brain damage of adult patients who had suffered stroke, accidents, or disease. These scientists gathered information by first studying the behavior of patients who had lost some function, such as the ability to speak or read. In the autopsies of many of these patients, they were able to link the loss of function to specific damaged areas of the brain. Some of the highlights of this foundation period are reviewed in this section. A widely held notion in the nineteenth century was the belief in //phrenology,// which held that abnormal behavior and brain function could be predicted by examining the shape of the skull. Bumps on the head were thought to reveal information about the brain. In the 1860s, Paul Broca refuted the phrenology notion with his discovery during autopsies of adult patients who had lost the ability to speak and had subsequently died; he found that certain areas of the brain (in the left frontal lobe) were damaged (Broca, 1879). The importance of his discovery is widely recognized, and the loss of the ability to speak is often called //Broca’s aphasia//. John Hughlings Jackson (1874) added to this knowledge by showing that the areas of the human brain are intimately linked, so that damage to one part will reduce overall general functioning. Carl Wernicke (1908) described another portion of the brain (the temporal lobe) as the location for some of the functions of language. Sir Henry Head (1926) produced major contributions about **aphasia,** or the loss of speech, by developing a system for data collection and a test for diagnosing aphasia. Head showed that patients with aphasia did not suffer from generalized impairment of intellectual ability even though they had sustained brain damage and had lost language skills. James Hinshelwood (1917), an ophthalmologist, studied the condition of //word blindness,// which he defined as the inability to interpret written or printed language despite normal vision. Reporting on the case of an intelligent boy who was unable to learn to read, Hinshelwood speculated that the problem was due to a defect in the angular gyrus, a specific area of the brain. Kurt Goldstein (1939), a physician who treated brain-injured soldiers during Word War I, showed that brain damage affects an individual’s behavior. Among the characteristics he noted in the brain-injured soldiers were //perceptual impairment,// characterized by foreground-background (or figure-ground) difficulties, //distractibility// to external stimuli, and //perseveration// (the behavior of being locked into continually repeated action). Heinz Werner and Alfred Strauss continued Goldstein’s work, expanding the study from brain-injured soldiers to brain-injured children. In the 1930s, the field of learning disabilities proceeded from the foundation phase - with its focus on the study of the brain - to the transition phase - the clinical study of learning problems in children. However, brain research did not end. In fact, interest in this area today is greater than ever. Advancements in scientific technology allow much more sophisticated ways to study the brain and learning. Some of the recent discoveries, particularly the use of functional, magnetic resonance imaging, about the brain that have implications of learning disabilities are discussed in the chapter on medical aspects of learning disabilities.

The Transition Phase: Clinical Study of Children
During the transition phase (about 1930–1960), scientific studies of the brain were applied to the clinical study of children and translated into ways of teaching. Psychologists and educators developed instruments for assessment and teaching. During this period investigators also analyzed specific types of learning disorders. A number of scientists played important roles in developing this phase of the field. Foremost among them was Samuel T. Orton (1937), a neurologist, whose theory of the lack of cerebral dominance as a cause of children’s language disorders led to the development of a teaching method known as the Orton-Gillingham method (see the chapter on reading). The International Dyslexia Association (formerly The Orton Dyslexia Society) was created to honor Orton and to continue his work. It is an active force in the field of learning disabilities today. An educator in the 1940s, Grace Fernald (1988), also contributed to this period by establishing a remedial clinic at the University of California at Los Angeles, where she developed a remedial approach to teaching reading and spelling (see the chapters on oral language and written language). Maria Montessori (1964), a physician who worked with at-risk young children in Italy, demonstrated the value of using carefully planned materials and a structured environment to encourage children to learn and to develop cognitively. Among the other pioneers who helped develop the field of learning disabilities during this period are William Cruickshank, Ray Barsch, Marianne Frostig, Newell Kephart, Samuel Kirk, and Helmer Myklebust. During the transition phase, terminology changed many times, and various phrases were used to describe the //problem-brain injured// //children, Strauss syndrome, minimal brain dysfunction,// and finally, //learning disabilities//. The progression of terms reflects the historical progress of the field. Each term filled a need in its time, but each had inherent shortcomings.

The Brain-Injured Child
Pioneering work conducted by Alfred Strauss and Laura Lehtinen (1947) was reported in their book //Psychopathology and Education of the Brain Injured Child//. They identified a new category of exceptional youngsters, classifying them as brain-injured children. Many of these youngsters had previously been classified as mentally retarded, emotionally disturbed, autistic, aphasic, or behaviorally maladjusted. Most of them exhibited such severe behavior characteristics that they were excluded from the public schools. (It is important to remember that at that time public schools had the right to exclude children with disabilities.) Further, the medical histories of these children indicated that they had suffered a brain injury at some time during their prenatal or postnatal lives. Seeking a medical explanation for the behavioral characteristics, Strauss hypothesized that the behaviors and learning patterns of these children were manifestations of brain injury. This diagnosis was unique at the time because other professionals had explained the behavioral abnormalities of many such children as stemming from emotional origins. Strauss believed that other children who exhibited characteristics similar to those of the subjects in his studies had also suffered an injury to the brain. Strauss thought that the injury to the brain had occurred during one of three periods in the child’s life: //before// birth (the prenatal stage), //during// the birth process, or at some point //after// birth. An example of an injury occurring before birth is an infection such as German measles (rubella) contracted by the mother early in pregnancy and affecting the fetus. An example of an injury //during// birth could be any condition that would seriously reduce the infant’s supply of oxygen during the birth process (anoxia). //After// birth, the brain could be injured by a fall on the head or an excessively high fever in infancy or early childhood. Although such events could produce other disabilities (such as mental retardation or physical impairments), Strauss believed that they could also precipitate behavior and learning problems. //Perceptual disorder.// The child with a **perceptual disorder** may either experience a figure-ground distortion that causes confusion between the background and foreground, or may see parts instead of wholes. Figure-ground distortion is an inability to focus on an object without having its background or setting interfere with the perception. One teacher noted that when she wore a particular dress with polka dots, the children with perceptual disorders seemed compelled to touch it to verify what they thought they perceived. The ambiguity in perception that the normal observer senses in Figure 1 and Figure 2 can help one understand the unstable world of the child with a perceptual disorder. In Figure 1, one is to determine whether the picture is the face of an old woman or a young woman. In Figure 2, one is asked to look at the drawing and then to sketch it from memory. (Even copying this figure while viewing it may prove difficult.) These illustrations contain reversible figure-ground patterns that produce confusion, or a shifting of background and foreground much like that constantly experienced by a child with perceptual disorders.
 * Behavioral Characteristics:** Strauss identified the following behavioral characteristics of brain-injured children. It is of historical interest to note that Strauss stressed behavioral characteristics more than learning characteristics. As leaders in learning disabilities sought supportive legislation from Congress in the 1960s and 1970s, they shifted the emphasis to disorders in learning. Currently, many of the behavioral characteristics first identified by Strauss are recognized as key characteristics of children with attention deficit hyperactivity disorder.
 * Figure 1. Do you see a young woman or an old woman in this picture?**
 * Figure 2. Examine this drawing and then try to sketch it from memory.**



Seeing parts instead of wholes can be illustrated with the capital letter **A** **.** A child with a perceptual disorder might perceive three unrelated lines rather than a meaningful whole. Or instead of the whole figure of a square, the child might perceive four unrelated lines. A child might also focus on an irrelevant detail in a picture and thereby lose the meaning of the entire picture. //Perseveration:// A child with **perseveration** continues an activity once it has started and has difficulty changing to another. For example, after writing the letter //a// the three times required in a writing lesson, the perseverative child may not be able to stop but instead will continue this activity onto the desk and up the wall. Another example of perseveration is the child who persists in singing a phrase from a television commercial over and over. //Conceptual disorders:// A child with **conceptual disorders** is unable to organize materials and thoughts in a normal manner. This is a disturbance in the cognitive abilities that affects comprehension skills in reading and listening. One 10-year-old girl was unable to differentiate the concepts of //sugar// and //salt// ; since the two substances have a similar appearance, she confused the words symbolizing those concepts. Today there is a renewed interest in the thinking problems of individuals with learning disabilities and in instruction in cognitive strategies. //Hyperactivity:// Strauss noted that brain-injured children were hyperactive, explosive, erratic, or otherwise uninhibited in behavior. They were continually in motion, blew up easily, and were easily distracted from the task at hand. //Distractibility:// The behavior of distractibility refers to the inability to concentrate or inattentiveness. Today, children with these characteristics are seen as having hyperactive and impulsive behavior and are identified as children with attention deficit disorders. //Soft Neurological Signs:// These symptoms provide evidence of neurological dysfunction. The term **soft neurological signs** refers to subtle rather than obvious or severe evidence of neurological abnormalities. An awkwardness in gait, for example, is considered a soft neurological sign. Another soft sign is difficulty in performing fine motor skills, such as buttoning or cutting with scissors. Strauss’s initial work alerted physicians to events that might be related to brain injury. An alarmingly large number of possibilities are identified as potential causes of such injury. In the //prenatal stage,// injury could result from such conditions in the mother as the RH factor or from disease during the pregnancy such as rubell. During the //birth process,// insufficient oxygen; prematurity; a long, hard labor; a difficult delivery; or a purposely delayed birth could injure the baby’s brain. //After birth,// childhood diseases (such as encephalitis and meningitis), the dehydration and extremely high fevers that accompany illnesses, some head injuries sustained in accidents, and baby shaking have also been linked to brain injury. (It must be remembered, however, that these events are merely //possible// causes of brain injury. Many children with case histories of such events apparently escape harm, whereas other children with clear symptoms of brain injury have no such events in their case histories.) Strauss and his coworkers laid the foundation for the field of learning disabilities by (1) perceiving similar characteristics in a diverse group of children who had been misdiagnosed by specialists, misunderstood by parents, and often discarded by society; (2) planning and implementing educational settings and procedures for teaching these children successfully; and (3) alerting many professions to the existence of a new category of disabilities.
 * Teaching the Brain-Injured Child:** Besides developing a theory of the brain-injured child, Strauss and Lehtinen (1947) presented a plan for teaching such children. Their suggested methods, materials, and settings differed dramatically from those of a regular classroom. For example, they designed a learning environment that reduced distraction and hyperactivity. All stimulating visual materials such as bulletin boards or pictures were removed, and the windowpanes were painted to conceal overstimulating outside views. Further, they recommended that the teacher avoid wearing jewelry and dress in a manner that would reduce distractions. The students’ desks were placed against a wall, behind a screen, or in a partitioned cubicle. Special materials were constructed to aid students in the perception of visual forms and in the organization of space and form. Strauss’s work and theory were welcomed because they offered an alternative diagnosis for children who previously had been given many other labels, such as badly behaved, emotionally disturbed, lazy, careless, or stupid. This fresh view was very welcome to parents who had been blamed for creating psychological distress that caused disorders in their children, had been told that their children did not fit into a public school setting, or had vainly sought a sensible diagnosis. This new approach offered such parents a meaningful, logical, and hopeful analysis of their child.

The Search for Other Terminology
Doubts about the usefulness of the term //brain-injured// arose soon after the publication of Strauss and Lehtinen’s book in 1947. Critics pointed out that the term was confusing. Educators found it was difficult to use the medical term //brain-injured// in communicating with parents, and the term was frightening to children. Other terms were soon suggested to identify these children. The term //Strauss syndrome// was recommended by Stevens and Birch (1957) to pay tribute to Strauss’s pioneering work. This term focused on the behavioral characteristics, not the learning characteristics. Minimal brain dysfunction (MBD) was a term recommended by the Department of Health, Education,and Welfare (Clements, 1966). This report classified children with various brain impairments along a scale ranging from mild to severe. At the severe end of the scale are children with obvious brain damage, such as cerebral palsy or epilepsy. At the opposite end are children with minimal impairment that affect behavior and learning in more subtle ways. The term //minimal brain dysfunction// described the child with near-average intelligence and with certain learning and behavioral disorders associated with deviations or dysfunctions of the central nervous system. Thus, MBD differentiated the minimally involved child from the child with major brain disorders. Many medical professionals employed the term //MBD// when diagnosing children. Many other terms used to refer to these children were classified into two groups: (1) terms that identified the //biological causes// of the condition (for example, neurological dysfunction or brain injury), and (2) terms that identified the //behavioral consequences// (such as hyperactivity or distractibility).
 * The “Strauss syndrome” child exhibited the following behaviors:
 * Erratic and inappropriate behavior on mild provocation
 * Increased motor activity disproportionate to the stimulus
 * Poor organization of behavior
 * Distractibility of more than the ordinary degree under ordinary conditions
 * Persistent faulty perceptions
 * Persistent hyperactivity
 * Awkwardness and consistently poor motor performance

Acceptance of the Term //Learning Disabilities//
None of the many recommended terms for describing these children received general acceptance. It was clear that another term was needed that would more meaningfully describe these children. In 1963 Samuel Kirk first proposed the term //learning disabilities// at a meeting of concerned parents and professionals (Kirk, 1963). Accepted immediately, //learning disabilities// continues to be used and appears to be a satisfactory term that gained rapid acceptance. It is an umbrella concept, encompassing many diverse types of learning problems without identifying the specific area of the student’s deficiencies. The advantages of the term //learning disabilities// are that it focuses on the educational problems, avoids the medical implications, and seems to be acceptable to parents, teachers, and students. The term //learning disabilities// has now been written into law in the United States and other countries throughout the world. It successfully serves as a recognized way to refer to individuals with the problems that are the concern of this book.

INTEGRATION PHASE: RAPID EXPANSION OF SCHOOL PROGRAMS
During the integration phase (about 1960–1980), learning disabilities became an established discipline in the schools throughout the United States. The field grew rapidly as learning disabilities programs were established, teachers were trained, and children began to receive services.

Rapid Growth of Public School Learning Disabilities Programs
One of the first attempts to establish a public school learning disabilities program occurred in Syracuse, New York (Cruickshank, Bentzen, Ratzeburgh, & Tannhauser, 1961). This demonstration-pilot project adapted and refined the educational methods proposed by Strauss and Lehtinen (1947) for brain-injured students in the public schools. The early plans for teaching these students called for the following conditions in the teaching environment (Cruickshank et al., 1961): By the 1960s and 1970s, public school learning disabilities programs were rapidly being established throughout the nation. Several forces promoted this needed development: parental pressures, the increase in professional information, the availability of teacher training programs, and the first state laws requiring services for students with learning disabilities. Most of the early programs were for students at the elementary level. Children were placed in special classes following the traditional delivery system in special education at that time. Later in this period, resource room programs were introduced, and the secondary schools also began to serve adolescent students with learning disabilities. Many new tests and teaching materials were developed during this period to service the growing number of students identified under the category of //learning disabilities// in the schools.
 * Reducing unessential visual and auditory environmental stimuli
 * Reducing the space in which the student works
 * Providing a highly structured schedule
 * Increasing the stimulus value of the teaching materials

Increased Legislative Support for Teacher Training
A major advancement in the field occurred in 1969 when Congress passed the Children with Specific Learning Disabilities Act (PL 91–230). For the first time, the field of learning disabilities was acknowledged in federal law, with funding provided for teaching training. This law set the stage for including learning disabilities in subsequent federal and state laws. In the 1970s, federal funding supported the development of learning disabilities model programs throughout the country. Called Child Service Demonstration Centers (CSDCs), these were model projects that provided opportunities for innovation and experimentation, and stimulated the development of learning disabilities practices throughout the nation.