Learning Disability Subtyping: Neuropsychological Foundations, Conceptual Models, and Issues in Clinical Differentiation PDF
Preview Learning Disability Subtyping: Neuropsychological Foundations, Conceptual Models, and Issues in Clinical Differentiation
Learning Disability Subtyping Stephen R. Hooper W. Grant Willis Learning Disability Subtyping Neuropsychological Foundations, Conceptual Models, and Issues in Clinical Differentiation Springer-Verlag New York Berlin Heidelberg London Paris Tokyo Stephen R. Hooper Ph.D. The Clinical Center for the Study of Development and Learning Department of Psychiatry University of North Carolina School of Medicine Chapel Hill, NC 27599-7255, USA W. Grant Willis Ph.D. Department of Psychology University of Rhode Island Kingston, RI 02881-0808, USA Library of Congress Cataloging-in-Publication Data Hooper, Stephen R. Learning disability subtyping : neuropsychological foundations, conceptual models, and issues in clinical differentiation / Stephen R. Hooper, W. Grant Willis. p. cm. Bibliography: p. Includes index. ISBN (invalid) 0-387-96803-3 (alk. paper) I. Learning disabilities. I. Willis, W. Grant. II. Title. [DNLM: I. Learning Disorders-classification. WS 15 H788L] RJ506.L4H66 1989 GI8.92'858-dcI9 DNLMlDLC for Library of Congress 88-39218 Printed on acid-free paper. © 1989 by Springer-Verlag New York Inc. Softcover reprint of the hardcover I st edition 1989 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer-Verlag, 175 Fifth Avenue, New York, NY 10010, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, com puter software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use of general descriptive names, trade names, trademarks, etc. in this publication, even if the former are not especially identified, is not to be taken as a sign that such names, as understood by the Trade Marks and Merchandise Marks Act, may accordingly be used freely by anyone. Typeset by Asco Trade Typesetting Ltd., North Point, Hong Kong. 9 8 7 6 5 4 3 2 I ISBN-13: 978-1-4613-8812-8 e-ISBN-13: 978-1-4613-8810-4 001: 10.1007/978-1-4613-8810-4 To my family (S.R.H.) To people with learning disabilities (W.G. W.) Foreword The publication of this very important volume comes at a timely juncture in the history of learning disabilities. The focus of this volume is on developing a multidisciplinary understanding of the complexities of the research on learning disabilities and its various sUbtypes. It also will serve as an important compendium of the subtyping literature, particularly with respect to pertinent issues of nosology, specific sUbtyping models, neuro psychological diagnosis, and treatment. As the authors so correctly suggest, the differential diagnosis of learning disabilities subtypes is a critical first step in developing theoretically sound programs of psychoeducational intervention. Clearly, one must have some idea about the general abilities of a child before realistic expectations can be charted. Also, how can one plan a program of intervention without some knowledge of the deficient components of achievement within a do main? Does it not make both conceptual and practical sense to identify an individual's relative strengths and weaknesses so that abilities or strengths can be utilized to optimize functioning in areas of deficit? Although these all sound like reasonable precursors to assisting individuals in need of academic assistance, there are those who would argue otherwise. Impor tantly, however, the Director of the National Institutes of Health, in a recent report to Congress, advocates exactly what this volume proposes. Indeed, there are important needs to be addressed, and the literature reviewed herein strongly supports the conclusions drawn by these authors. There is ample evidence of subtypes of learning disabilities, and a concur rent need exists for a standardized nosology. There is a need for more psychometrically· refined neuropsychological and neurodiagnostic proce dures, both for children currently in school and for those of preschool age. There also is an urgent need for standardized markers and variables that should be employed in all research efforts. There are studies currently underway that are investigating the very specific issue of whether sUbtype by-treatment interactions occur and to what degree. Although there are few actual data about this important issue, within the next 5 years, some conclusions may indeed be warranted. This volume succeeds in outlining many of the issues with respect to treatment. viii Foreword Thus, in my view, the authors of this volume have provided us all (e.g., psychologists, educators, physicians, and parents) with a comprehensive neuropsychological perspective as to what the presumed neurological basis is, how cognitive, academic, linguistic, and social-emotional systems are implicated, how the subtypes can be viewed as discretely different, and what the literature says about assessment and intervention. This book does far more than summarize the present state of affairs in a well written man ner; it provides a solid conceptual perspective about where we have been, what we have done, and perhaps most important, what we need to do next to ensure that learning-disabled individuals will profit from our most productive research efforts. University of Georgia George W. Hynd Athens, Georgia Preface The conceptualization of learning disabilities has a long history. Case de scriptions of children with unusual learning profiles, for example, were pre sented in the 1800s. Although the actual term, learning disability, was not coined until the middle 1960s, the clinical and research legacy left a trail of findings supporting the existence of such a learning phenomenon. Many of the findings related to this phenomenon, however, were conftictual and, subsequently, provided little guidance to the clinician and researcher in terested in working with these children. These concerns did not constrain researchers' efforts to investigate this disorder but, unfortunately, these efforts rarely occurred from a unified perspective. From both research and clinical perspectives, the study of learning dis abilities had become a burdensome and confusing quagmire. There were blatant problems in the clinical components of evaluation, diagnosis, and treatment. Problems also existed in even more fundamental aspects of this disorder, including such basics as definitional issues and conceptual found ations. Although clinicians and researchers continue to struggle with these difficulties when working with this population, there have been relatively recent advances in this field that may help to bring greater clarification and understanding to this clinical and research area. Over the past three decades, there has been a steady proliferation of research investigating the neuropsychological factors contributing to learn ing disabilities. One of the major research trends that has emerged from these efforts is that a learning disability actually is a generic classification that represents a heterogeneous group of neurologically based disorders. The identification of reliable subtypes has the potential to lend assistance to the evaluation and diagnosis of learning disorders. It also has the poten tial to improve the specificity of treatment programs and intervention plans for these individuals. By attempting to classify learning problems according to more homogeneous groupings, researchers will be able to begin to bring some clarity to the confusing mass of learning disability research that has been conducted to date. Research efforts ultimately will become more theoretically sound and, thus, clinically useful if a reliable and valid clas sification model can be developed. x Preface Given this evolving literature on learning disability subtyping, it be comes important for this information to be gathered from time to time in a single resource so that it can be evaluated efficiently and effectively. Rourke (1985) presented the first publication addressing this need, largely focusing on his landmark efforts in the subtyping area. In a complementary fashion, this volume also addresses this need by providing a comprehensive compendium of the subtyping models derived to date. As such, the volume is intended for students, practitioners, and researchers across a wide array of fields who are interested in learning disability subtyping. The book is divided into four major sections. The first section is con cerned with providing a historical and conceptual framework from which to view the sUbtyping efforts. Chapter 1 provides an overview of historical antecedents to learning disabilities, along with a discussion of definitional issues crucial to this field. Chapter 2 is concerned with the neurological foundations for the study of learning disability subtyping and its proposed classification models. The second section is devoted exclusively to the various subtyping models. Chapter 3 deals with an overview of all of the clinical-inferential sub typing attempts completed to date, and Chapter 4 presents an overview of classification models employing empirical strategies and techniques. Specific issues directly related to subtype derivation are discussed in Chap ter 5. The third section deals with specific components of the sub typing pro cess. Chapter 6 is concerned with the neuropsychological assessment of subtypes, and Chapter 7 deals with emergent concerns pertaining to impor tant social-emotional features of learning disability subtypes. Chapter 8 provides an overview of treatment models and issues related to interven tion programs with children showing particular learning profiles. A particu lar emphasis in this chapter is placed on the few studies that have been conducted to date exploring treatment interventions for speCIfic subtypes. Finally, the last section provides a summary of the literature published to date, emphasizing recent advances and future directions of the subtyping endeavor. The classification of children with learning disabilities has extraordinary potential to bring greater clarity to clinical and experimental efforts in this field. We hope that our overview of the subtyping literature and related issues contributes to this important endeavor. Chapel Hill, NC Stephen R. Hooper Kingston, RI W. Grant Willis Acknowledgments Although the time spent drafting and redrafting this volume was great, our efforts would never have reached fruition without the help of several "significant others." We would like to extend our sincere appreciation to Teresa Buckner and Elizabeth Scott at the Clinical Center for the Study of Development and Learning for their efficient clerical assistance in preparing this volume. We also would like to thank Dr. Mary Gail Becker at The Pennsylvania State University for her input on several of the chapters. Finally, we would be remiss if a heart-felt "thank you" were not given to the editorial staff at Springer-Verlag. In particular, we would like to thank Dr. Robert Kidd for his unending patience with us during the process of completing this volume. Despite this excellent support, how ever, we remain responsible for any shortcomings of this volume.
The list of books you might like
