A
PAEDIATRIC APPROACH TO LEARNING DISABILITIES
Oberklaid F
Centre for Community Child Health
Royal Children’s Hospital, Melbourne,
Australia
Objective: Develop
a practical conceptual approach to the assessment and management of
learning difficulties and school problems that can be incorporated into
general paediatric practice.
Methods: The
assessment approach is predicated on a transactional model of child
development. This asserts that
development is the result of a complex series of transactions between
biological or intrinsic factors in the child and environmental factors and
life experiences. The
assessment model systematically evaluates constitutional and environmental
factors as potential contributors to the child’s learning
difficulties. In particular,
it assesses subtle areas of development (motor function, visuo-motor
integration, temporal-high sequential organisation, language, attention and
related behaviours) and adopts a non-diagnostic, individual differences
approach in which strengths and weaknesses are described in the context of
demands and expectations.
Results: Process
evaluation of the assessment model reveals high parent and school teacher
satisfaction and a high rate of implementation and recommendations. The model has been successfully
taught to paediatricians and paediatric trainees for over a decade, and
there is evidence of its widespread adoption in the paediatric community.
Conclusions: Paediatricians
are able to confidently assess and contribute to management of children
with learning difficulties using a conceptual model that is a natural
extension of their traditional practice role.