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Gestalt and Client Centered Therapy

In: Philosophy and Psychology

Submitted By omega5
Words 5077
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Specific Learning Disorders

Table of contents
Index Pages
Introduction 3
Diagnostic criteria 4
Aetiology 11
Differential diagnosis 14
Comorbodity 16
Prevalence 16
Prevention and Treatment 17
Prognosis 18
Multicultural factors 19
Social factors 19
Conclusion 20
References 21

A tiny fragment of words used, labels for children and people with specific learning disorders. If only they understood
The most basic definition of a specific learning disorder/disability according to Gould (2005) cited in Rörich (2008) is when a learner has an average to above average intelligence, with normal vision and hearing, and receives the same teaching experiences as other learners his age. He, however, underachieves. He is unable to keep up with his peers and generally cannot cope with the demands of the school (pp16).
Margari (2013) defines SLD’s as that which are characterizations of academic functioning that are below the level that would be expected given their age, Intelligent Quotient and grade level in school, and interfere significantly with academic performances or daily life activities that require reading, writing or calculation skills.
The gist of it, is that specific learning disorders are neurodevelopmental/cognitive disorders that Hulme and Snowling (2009,pp22) define as “typically characterized by slow rates of development, either in specific domain (specific learning disabilities such as dyslexia or mathematics disorder) or more generally across many domains (general learning difficulties or mental retardation).
Finally, Rorich (2008, pp16) explains that the South African contexts defines these, as barriers to learning or learning disabilities in which then a "Specific learning disability", is a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell or to do mathematical calculations.
The disorder is identified as a “discrepancy of more than two standard deviations between levels of achievement and intelligence” (Kearney, 2010,pp77).
Specific learning disorders is encapsulated in the DSM 5 as an umbrella term of neurodevelopmental learning disorders that negatively affect the “normal” acquisition of academic skills. These skills were previously categorized separately as reading, writing and mathematics disorders, respectively.
Diagnostic Criteria
The clinical description of Specific according to the DSM 5 (American Psychiatric Association, 2013, 66-74) is explained as:
A. Difficulties learning and using academic skills, as indicated by the presence of at least one of the following symptoms that have persisted for at least 6 months, despite the provision of interventions that target those difficulties:
1. Inaccurate or slow and effortful word reading (e.g., reads single words aloud incorrectly or slowly and hesitantly, frequently guesses words, has difficulty sounding out words).
2. Difficulty understanding the meaning of what is read (e.g., may read text accurately but not understand the sequence, relationships, inferences, or deeper meanings of what is read).
3. Difficulties with spelling (e.g., may add, omit, or substitute vowels or consonants).
4. Difficulties with written expression (e.g., makes multiple grammatical or punctua­tion errors within sentences; employs poor paragraph organization; written expression of ideas lacks clarity).
5. Difficulties mastering number sense, number facts, or calculation (e.g., has poor understanding of numbers, their magnitude, and relationships; counts on fingers to add single-digit numbers instead of recalling the math fact as peers do; gets lost in the midst of arithmetic computation and may switch procedures).
6. Difficulties with mathematical reasoning (e.g., has severe difficulty applying mathematical concepts, facts, or procedures to solve quantitative problems).
B. The affected academic skills are substantially and quantifiably below those expected for the individual’s chronological age, and cause significant interference with academic or occupational performance, or with activities of daily living, as confirmed by individually administered standardized achievement measures and comprehensive clinical assessment. For individuals age 17 years and older, a documented history of impairing learning difficulties may be substituted for the standardized assessment.
C. The learning difficulties begin during school-age years but may not become fully manifest until the demands for those affected academic skills exceed the individual’s limited capacities (e.g., as in timed tests, reading or writing lengthy complex reports for a tight deadline, excessively heavy academic loads).
D. The learning difficulties are not better accounted for by intellectual disabilities, uncorrected visual or auditory acuity, other mental or neurological disorders, psychosocial adversity, lack of proficiency in the language of academic instruction, or inadequate educational instruction.
Note; The four diagnostic criteria are to be met based on a clinical synthesis of the individual’s history (developmental, medical, family, educational), school reports, and psycho-educational assessment.
Coding note: Specify all academic domains and subskills that are impaired. When more than one domain is impaired, each one should be coded individually according to the following specifiers.
Specify if:
With impairment in reading:
Word reading accuracy
Reading rate or fluency
Reading comprehension
Note: Dyslexia is an alternative term used to refer to a pattern of learning difficulties characterized by problems with accurate or fluent word recognition, poor decoding, and poor spelling abilities. If dyslexia is used to specify this particular pattern of difficulties, it is important also to specify any additional difficulties that are present, such as difficulties with reading comprehension or math reasoning.
With impairment in written expression:
Spelling accuracy
Grammar and punctuation accuracy
Clarity or organization of written expression
With impairment in mathematics:
Number sense
Memorization of arithmetic facts
Accurate or fluent calculation
Accurate math reasoning
Note: Dyscalculia is an alternative term used to refer to a pattern of difficulties characterized by problems processing numerical information, learning arithmetic facts and performing accurate or fluent calculations. If dyscalculia is used to specify this particular pattern of mathematic difficulties, it is important also to specify any additional difficulties that are present, such as difficulties with math reasoning or word reasoning accuracy.
Specify current severity:
Some difficulties learning skills in one or two academic domains, but of mild enough severity that the individual may be able to compensate or function well when provided with appropriate accommodations or support services, especially during the school years.
Moderate: Marked difficulties learning skills in one or more academic domains, so that the individual is unlikely to become proficient without some intervals of intensive and specialized teaching during the school years. Some accommodations or supportive services at least part of the day at school, in the workplace, or at home may be needed to complete activities accurately and efficiently.
Severe: Severe difficulties learning skills, affecting several academic domains, so that the individual is unlikely to learn those skills without ongoing intensive individualized and specialized teaching for most of the school years. Even with an array of appropriate accommodations or services at home, at school, or in the workplace, the individual may not be able to complete all activities efficiently
Before a diagnosis is made in the case of specific learning disorders, it is the clinician’s responsibility to rule out all other factors that may contribute to the poor academic functioning. Kearney (2010) presented a case study in which the client, an 8 year old Hispanic girl, named presented poor achievement scores despite having a “normal” intelligence as described. In the case of Gisele, she was referred to a different school during the course of the year, she was being in taught in a second language and she never failed although she performed badly especially in tasks that required reading and writing.(pp75-77).
With regards to the brief case presented, in ruling out other possible factors to the poor academic functioning. The clinical psychologist, is expected to consider the home language of the client and whether the client perhaps cannot communicate in the language of teaching which is English. Secondly, the impact of being in different school environment may present adjustment issues, possible trauma and the client may perhaps be in need of time to adapt to the teaching style of the educator. A classic example if it were true, is presented in the parents of Gisele, Mr. and Mrs Garcia that ended up blaming the school instead for poor teaching practices and also then claiming that she had come from a “poorly funded school in general” (Kearney, 2010, pp77-78). This demonstrates that in specific learning disorders, the institution of learning matters, socio-economic factors may also contribute learning problems, as well as other biological factors such as deafness or being blind.
It is evident that a thorough clinical assessment must always be administered before diagnosing any client, with regards to the case of Gisele, examples of how a comprehensive clinical assessment is administered, will follow (Burke,2014,pp35-46): * Clinical interview: family history, history of client’s life, detailed description of presenting problem, information on attitudes, emotions and current/past behaviour as well as information on significant events of the client
According to Kearney (2010) environmental variables such as socio-cultural factors must be considered, which could affect a child’s school-based motivation, competiveness, attitudes and overall school achievement orientation, language deficits were argued by the author to also having the potential to predispose the child to social withdrawal that inhibits other forms of learning . Gisele was reported to have had being a bright student in her early years, also in her previous school she performed well in maths and science, achieving 88 in maths but had now dropped scores because the teacher “often taught maths and science using story problems, creative lab projects that involved reading and writing. Gisele, excelled in mathematics however she was not as strong in reading or writing. This goes back to the DSM 5 note, that suggest that specifications should be made in terms of specific learning disorders. Gisele may be able to solve mathematics calculations but having specific learning disorder with specifications in reading and writing.
Mental Status Examination: Critical analysis on intellectual functioning and thought processes
In addition, Gisele had an obvious misconfigured thought process, unlike other children she was unable to identify, recognise and integrate words and meanings. Gisele “had trouble identifying new and different words, even those in word groups such as law, paw and saw…she had trouble identifying letters of the alphabet” (Kearney, 2010. Pp76).
According to Jean Piaget’s theory of cognitive development, children Gisele’s age should have already mastered a phenomena called symbolic function from the ages of two to four years old, in which the child uses “symbols such as words, images and gestures to represent objects and events mentally” (Guavain and Parke, 2009,pp284). This would require the liquid recognition and identification of letters and words. Symbolic function exists within the preoperational period, whereby the “ability to use symbolic facilitates the learning of language” (Guavain and Parke, 2009, pp284). * Behavioural Assessment:
Gisele’s teacher complained that she was fidgety, inattentive but was not defiant, impolite, overactive etc. She however would make excuses for not completing her homework always suggesting that she had lost her homework. Gisele was observed as being disorganized, her study table was cluttered without any systematic way of doing things. (Kearney, 2010, pp76) * Medical Assessment: neuroimaging, physical examination
Although there was no medical assessment administered in Gisele’s case, neuroimaging would generally focus on the parietal and temporal lobes as they are the ones responsible for sensory integration, speech and language respectively (Weiten, 2010). In brain imaging, the Functional Magnetic Resonance Imaging (FMRI) scans provide “better images of the brain than CT scans” (Vythillingam, 2005 cited in Weiten, 2010, pp95). FMRI monitor blood flow and oxygen consumption in the brain to identify areas of high activity. In specific learning disorders, the scans will monitor the high oxygen activity level within the temporal-parietal region, as this will determine if energy is being used up in the form of sensory-motor integration. According to Kearney (2010) in dyslexia, a reading impairment, the temporal area showed less activity level as compared with people without dyslexia. Therefore, the normal information processing by neurons in the brain was either not present or limited. * Psychological Tests: Intelligence testing, Personality inventories, Projective and
Neuropsychological tests
Mr.Dartil, Gisele’s psychologist administered the Wechsler Intelligence scale for Children in which cognitive functioning is the central focus when assessing children. Gisele received an IQ score of 104 which suggests that she had an average intellectual quotient potential but had achieved below the norms. According to the clinician, Gisele was not “performing to her potential” (pp78).
According the Special Education Services: A Manual of Policies, Procedures and Guidelines (2006) cited in the paper presented by the British Columbia Association of School Psychologists (2007) that learning disorders are a result of genetic and/or neurobiological factors or injury that alters brain functioning in a manner which affects one or more processes related to learning. These disorders then are not due primarily to hearing and/or vision problems, socio-economic factors, cultural or linguistic differences, lack of motivation or ineffective teaching, although these factors may further complicate the challenges faced by individuals with learning disabilities. Learning disabilities may co-exist with various conditions including attention, behaviour and emotional disorders, sensory impairments or other medical conditions (pp.4)
In genetics, according to Mash and Wolfe (2013) children who lacked skills required for reading, such as hearing separate sounds of words, were more likely to have a parent with a related problem (pp372). The authors, Hawke, Wadsworth and Defries (2006) cited Kearney (2010) indicate that twin data revealed that reading disorders had a moderate to strong genetic influence, with chromosomes 1,2,3,6,11,13,15 and 18 were that were affected, which is in agreement with the findings of Gigorenko (2007) which identified that chromosome number 6 was predisposed children to a reading disorder. Though reading disorder in the new DSM 5 is referred to as a specific learning disorder with a reading impairment. Writing and mathematics disorder are not researched as much the reading disorder, as some researchers have suggested that a reading impairment is the root of all learning impairments. A reading impairment is called dyslexia. Dyslexia is defined by Reid (2009) as a processing difference, often characterized by difficulties in literacy acquisition affecting reading, writing and spelling. It can also have an impact on cognitive processes such as memory, speed of processing, time management, co-ordination and automaticity. There may be visual and/or phonological difficulties and there are usually some discrepancies in educational performances (pp4).

The neurological organic dysfunction, not only involves faults in the genetic makeup and chromosomes but also impediments in the certain structures of the brain. The brain, apart from the cerebrum and cerebellum, it is made of up four main functional lobes. Of the four lobes, the temporal and parietal lobes are involved in specific learning disorders. The temporal lobe “contains an area devoted to the auditory processing, called the primary core” (Weiten, 2011, pp103). According to Weiten (2011, pp102) damage to this part of the brain can result in impairments in the comprehension of speech and language. According to Pennington (1991,pp199) a problem in learning phonological labels could easily result from the left temporal lobe structural and functional anomalies.
In addition, another part of the brain that has a part to play in specific learning disorders, is the parietal lobe, which is “involved in integrating visual input and in monitoring the body’s position space” (Weiten, 2011, p102). Not only does the individual with a specific learning disorder fail to integrate what is seen, let’s say on the school board, but they are unable to perceive size and space, and so may write above lines, or misunderstand size and position. The primary visual cortex is not involved though it involves sight, because the reality of specific learning disorders is not the inability to see but to integrate and make sense of visual information.
Therefore the inability of the temporal-parietal lobe to process sensory input from sensory neurons, integrate the information and provide feedback through the motor neurons, results poor performance in reflection of information. In addition, according to Mash and Wolfe, the visual cortex plays a role in specific learning disorders. According to the authors, studies discovered that adults with reading disorders showed no activation in visual motion when asked to view randomly moving dots (pp374). This means that there was no response by the visual regions of these adults, who were not sensitive to the recognition of objects and would show notable defects in perception.
Persons with learning disorders have their short term and long-term memory affected hence they are unable to recall sensations to certain sounds and words, secondly, “language difficulties for people with reading disorders are specifically associated with the neurological processing of phonology and storage of such information into memory and behavioural and physiological abnormalities are found in processing of visual information” (Mash and Wolfe, 2013, pp374). Kearney (2010) found that cognitive deficits in learning disorders include perceptual problem such as distinguishing letters and words as well as linguistic processing problems.
In the left hemisphere of the brain responsible for language, the following segments of the brain are inactive in people with learning disorders: * Primary auditory cortex: responsible for electrical signals from receptors into sounds an sanctions of vowels and consonants * Auditory association area: responsible for basic sensory information from sounds and noises into recognisable patterns of words or music
(Mash and Wolfe, 2011, pp373)
Research suggests that these abnormalities can be detected at the earliest, in the prenatal stage of a foetus, whereby normal cell differentiation doesn’t take place in which each cell carries specific instruction and a memory for their task in the human body. Furthermore, apart from focus on neurological and developmental disabilities that impair functioning, Mash and Wolfe state that foetal alcohol syndrome, insulin-dependent diabetes, autism, irradiation and several other childhood diseases and trauma have been linked to nonverbal learning disorders.
Differential Diagnosis
Specific Learning Disorder and Attention Deficit/Hyperactivity Disorder
In ADHD poor academic achievement cannot be attributed to the inability to fulfil either of the academic skills such as reading, writing or mathematics due to defects in information processing. Rather poor academic achievement is a result of the inability to focus or be attentive to the school due to hyperactivity. Further inattention in specific learning disorders may be due to frustration from not being able to integrate, understand and meet the requirements of the work. Children/Individuals with ADHD may have normal sensory-motor processes and an average or above IQ score. There is a high correlation of SLD’s and ADHD in children, usually overlapping 30%-70% of the time (Mash and Wolfe, 2013).
Specific Leaning Disorder and Intellectual Disability
In Intellectual Disability, poor academic achievement is the result of “deficits in intellectual functions such as reasons, problem solving, planning, abstract thinking, judgement, academic learning, and learning from experience, confirmed by both clinical assessment and individualized, standardized intelligence testing” (APA, 2013, pp33). In specific learning disorder the individual may have an average or above average IQ score but still not be able to process and integrate information, on the other end, in intellectual disability the individuals possess an IQ score that is the expected for school requirements. The similarities entail the inability to conceptualize symbols and concepts. In both, there is a deficit in identification, integration and recognition of words, symbols. Both disorders satisfy the criteria A and B of specific learning disorders, but intellectual disability is ruled out in criteria C, which states that the individual may have SLD in the absence of an intellectual disability. The IQ score of intellectual disability is from 75 and below, whereas children/people with SLD’s may have an average to above average IQ.
In dementia, the inability to perform familiar tasks such as writing or reading and understanding what is read or mathematical, is a result of cognitive deterioration in the parts of the brain necessary for execution of sensory-motor functions.. The affected parts of brain lead to a cognitive breakdown. In Specific learning Disorders, the individual develops as a child with Specific learning disorder, in the latter, dementia develops over time (usually thought to be for only older people). The inability to carry out academic functions, is a result of cognitive deterioration that may be well inherited. People with dementia lose the memory capacity to executing tasks such as writing, whereas in SLD’s the individuals are born with this deficit from childhood. Dementia can be understood as a set of multiple cognitive developmental impairments that affect the human memory and cause loss of executive functioning (Baiyewu, Jeste, Reiger, Sirovatka and Sunderland (2007).
Developmental Coordination Disorder
In specific learning disorder the individual is unable to fulfil the writing aspect of academic skills due to not being able to recognize, interpret or integrate the words or symbols. However in DCD, failure to write is due to a low acquisition and execution of the motor skills that then affect academic/school productivity. The fine and gross motor skills attributed to gripping and handwriting are impaired. Kearney (2010) found that children with writing and spelling difficulties also have trouble producing letters, organizing finger movements, mapping out written words phonologically, and integrating visual-motor stimuli.
Learning difficulties
Specific learning disorder is not the result of injury to neurological and sensory organs. Challenges in the sensory organs may include visual and hearing impairments, at other times traumatic brain injury may affect parts of the brain associated with sensory-integration and processing.
Results from a quantitative study in the article, Neuropsychopathological comorbidities in learning disorders found that in terms of Specific Learning Disorders “ADHD was present in 33%, Anxiety Disorder in 28.8%, Developmental Coordination Disorder in 17.8%, Language Disorder in 11% and Mood Disorder in 9.4% of patients.”(Margari,2013). Kearney (2010) found that learning disorders and attention deficit disorder co-occur in many cases (25%-80%) suggesting that causes overlap (pp81).
Further according to research, 20% of children with SLD have associated ADHD as comorbidity and vice versa. In addition intellectual disabilities and Specific Learning disorders are strongly associated.
The prevalence among adults is argued to be approximately 4% although information is scarce, in school-going children it ranges from 5%-15% (APA, 2013:pp70). As a result of the disorder being genetic, “the familial risk is therefore a useful indicator of dyslexia and is supported by prevalence rates” (Molfese, 2008 cited in Reid, 2009, pp15)

Prevention and Treatment
Mash and Wolfe (2013) believe that training children in phonological awareness activities at an early age may prevent subsequent reading problems among children at risk (pp375). The sooner the identification of learning challenges, the better it is for the child to get remediated. Children with specific learning disorders may need to use alternative methods to conventional teaching strategies employed by the school curriculum. Teachers may need to focus on building on the others strengths of the child such as art, music, drama, role-play and sports to teach.
Treatment typically requires efforts of a multidisciplinary that is inclusive of parents, teachers, peers and psychologists. By means of both cognitive behavioural therapy and psycho-education, a child’s attitude towards learning can be improved through support and investing in alternative methods of teaching.
According to Sams (2006) cited in Azam (2012) the identification of behaviours and feelings is linked to verbal ability and the identification of thoughts is associated with general IQ, thoughts, feelings, and behaviours that are more likely to be understood and correctly identified by people with higher verbal ability and IQ . Therefore for mild specific learning disorder not coupled with intellectual disability, CBT has been found to “help at least part of this population stabilise their mood, resume a more normal life, and engage in society in productive ways” (Azam, 2012.pp17).
While much focus has been on the individuals diagnosed with learning disorders, an institutional framework that will move towards improving mental health services in schools should be considers. Infact, Cowan and Rossen (2014) suggest a multitiered system of supports (MTSS), a framework that is rooted on the basis of providing a continuum of the delivery of services, integrated within a learning environment. These tiers are made up of three goals (Cowen and Rossen, 2014, pp10-11)
Goal 1: Universal wellness promotion and prevention
This goal focuses on promoting positive behaviour and safety, resilience and developing a supportive school environment whereby all students are valued and respected, while those are at risk for mental health problems are identified. The aim is to instil effective primary intervention through screening processes, skills development for both learners/students and staff.
Goal 2: Targeted prevention and intervention
Focus is on the identified problem at classroom level and even in the school. at this level, it is the responsibility of the mental health professionals to assess and guide interventions in collaboration with teachers.
Goal 3: Individual/Tertiary intervention
At this level both direct and indirect mental health services are provided such as counselling. The schools’ employed mental health professionals are required to coordinate with external clinicians and community agencies for intensive clinical service.
Above everything, awareness in schools could be helpful in reducing the effects of stigma and bullying learners/students.
Specific learning disorder with a specific impairment is usually diagnosed during the school going ages. That is usually when the symptoms are highlighted and easily identifiable, once the individual is required to meet academic outcomes and is unable to satisfy the demands. The disorder usually carries out throughout highschool, however given that remedial and psycho-education intervention is provided; students may be able to cope in learning environments, through “developing appropriate strategies for problem-solving and self-control in children” (Jena, 2013,pp123-124).
Multicultural factors
In a country like South Africa, where there are 12 official languages and where technology is not as evolved as in the States, prevalence rates are difficult to determine, but also identifying children with specific learning disorders is problematic. Firstly, in schools where English is still the medium of instruction, children may be either misdiagnosed for specific learning disorders whereas they are not English fluent. Vice versa, the scholar could be perceived as slow to understand English, whereas they have a learning disorder. Secondly, because technology is not as advanced in Africa, diagnosis is delayed, further delaying treatment. Thirdly, one should consider if all schools in South Africa have mental helath professionals particularly, school psychologists. School psychologists “can be particularly good resource to help identify assessment tools and collect, analyse, and interpret”( Cowen and Rossen, 2014, pp12)
Lastly, in intervention, understanding the cultural attitudes and persona experiences of families towards mental health is critical for family engagement as a resource (Cowen and Rossen, 2014).
Social factors
In South Africa, where poverty is rife, as according to Statistics SA (2014) owing to 10, 2 million people living beyond the food line. It is clear every child is offered the opportunity to go to school where specific learning disorders are highlighted as learners struggle to come to grips with the academic requirements. In addition, Foy and Perrin cited in Cowen and Rossen (2014) argue that in many communities, especially rural areas, school still remain the only source of mental health supports for children. Furthermore, an estimated 70% of all learners who receive mental health support, initially receive this at school (pp9).
Specific learning disorders are chronic conditions that cannot be “cured” because of its genetic origins. Specific learning disorders are different from what the school system regards as learning disabilities. Learning disabilities include mental, physical and social challenges that pose as a barrier to learning.
To determine a disorder in learner, standardized psychometric tools should be used in conjunction with reports from the family and educators. However through effective intervention involving remedial classes and alternative forms of teaching by educators, children may thrive and reach their full potential. Like any individual social support remains the most contribute factor in building esteem and the courage to confront one’s own challenges.

American Psychiatric Association (2013) Diagnostic Statistical Manual of Mental Disorders (5th ed) Washington, DC
Baiyewu, O., Jeste, D.V., Reiger,A.D., Sirovatka,P.,Sunderland,T (2007) Diagnostic issues in Dementia. Advancing the Research Agenda in DSM-V (1st ed) USA: American Psychiatric Association
Azam, K., Hassiotis, A.,King, M.,Martin, S., Sefarty,M., Strydom, A (2012) A manual for cognitive behaviour therapy for people with learning disabilities and common mental disorders. Camden & Islington NHS Foundation Trust & University College London
Burke, A., Austin, T., Bezuidenhout, C., Both, K., Du Plessis, E., Du Plessis, L., Jordaan, E., Lak, M., Moletsane, M., Nel, J., Pillay, B., Ure, G., Visser, C., Van Krosigk.,Vorster, A (2014) Abnormal Psychology: A South African Perspective (2nd ed revised) S.A, Cape Town :Oxford University Press
Cowen, C.K., Rossen, E (2014) Supporting the mental health needs of children in schools. Phi Delta Kappan.96 (4) 7-13
Guavain, M., Parke, D.R., (2009) Child Psychology: A Contemporary Viewpoint. New York: McGrawHill
Hulme, C & Snowling, J.M (2009) Developmental Disorders of language Learning and Cognition. UK, West Sussex: Wiley-BlackWell
Jena, S.P.K., (2013) Learning Disability: Theory to Practice. India: Sage Publications
Karande S, Satam N, Kulkarni M, Sholapurwala R, Chitre A, Shah N. Clinical and psychoeducational profile of children with specific learning disability and co-occurring attention-deficit hyperactivity disorder. Indian J Med 61:639-647
Accessed: on the 13 January 2015
Kearney, A.C (2010) Casebook in Childhood Behaviour Disorders (4th ed) Belmont: Wadsworth
Margari, L., Buttiglione, M., Craig, F., Cristella, F.,de Giambattista, C., Matera, E.,Operto, F., Simone, M (2013)Neuro-psychopathological comorbidities in learning disorders. Article Abstract.198. doi:10.1186/1471-2377-13-198
Mash, E.J., Wolfe, A.D., (2013) Abnormal Child Psychology (5th ed) Wadsworth: USA
Reid, G (2009) Dyslexia :A Practioners Handbook (4th ed) West Sussex: Wiley-Blackwell
Pennington, B.F (1991) Genetic and neurological Influences on Reading Disability: An Overview (pp191-201) university of Denver, USA: Kluwer Academic Publishers
Rorich, M.J.V (2008) Support to parents with children with learning disabilities. Unpublished master’s thesis. University of South Africa: Pretoria
Best Practice Guidelines for the Assessment, Diagnosis and Identification of Students With Learning Disabilities (2007) retrieved from : Statistics South Africa. Poverty Trends in South Africa: An examination of absolute poverty between 2006 and 2011 (2014) ISBN 978-0-621-41873-6.South Africa, Pretoria: Statistics South Africa
Weiten, W (2010) Psychology :Themes and Variations (8th ed) Wadsworth: Belmont…...

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...the claim that Person-Centered Therapy offers the therapist all that he/she will need to treat clients Person-centered therapy, which is also known as client-centered, non-directive, or Rogerian therapy, is an approach to counseling and psychotherapy that places much of the responsibility for the treatment process on the client, with the therapist taking a nondirective role. Developed in the 1930s by the American psychologist Carl Rogers, client-centered therapy departed from the typically formal, detached role of the therapist emphasized in psychoanalysis and other forms of treatment. Rogers believed that therapy should take place in a supportive environment created by a close personal relationship between client and therapist. Rogers's introduction of the term "client" rather than "patient" expresses his rejection of the traditionally hierarchical relationship between therapist and client and his view of them as equals. In person-centered therapy, the client determines the general direction of therapy, while the therapist seeks to increase the client's insight and self-understanding through informal clarifying questions. This essay will evaluate this type of therapy to establish if it is the only therapy needed by therapist to treat their clients. Rogers was a humanistic therapist which differed greatly from other approaches at that time which were based on the psychodynamic ideas of Freud, Carl Yung, Alfred Adler and others. Person Centred Therapy is not active,......

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Behavior Modification and Person-Centered Therapy

...MODIFICATION AND PERSON-CENTERED THERAPY Behavior Modification and Person-Centered Therapy Grand Canyon University PSY 255 May 15, 2012 Behavior Modification and Person-Centered Therapy Cognitive behavior therapy (CBT) is a treatment that helps patients to understand the feelings and thought that influence his or her behavior. Cognitive behavior treatment can help outpatient client deal with his or her problems. Many approaches can be used for outpatient therapy, two such treatments are Behavior Modification and Person-Centered Therapy. Cognitive treatments are used to treat disorders like depression, addiction, and anxiety, with the right treatment patient can become capable at fulfilling his or her potential for growth. Carl Rogers, a humanistic American psychologist, developed the client-centered therapy. His ideas have been used all over the world. Rogers’s person-centered approach has been used in education, parenting, organizational development, recovery, and administration (Natiello, n.d.). Roger believed that humans “naturally strive to reach an optimal sense of satisfaction with our lives” (Burger, 2008, p. 292.). Roger believe that therapist’s job is to provide an atmosphere where the clients can change themselves, therapist are not there to change the client. He believes that each person can develop in a positive self-actualizing fashion unless in some way his or her progress is impeded (Burger, 2008). Person-centered therapy or client-centered therapy......

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Person Centered Therapy

...Running Head: A BRIEF CRITIQUE OF PERSON CENTERED THERAPY A Brief Critique of Person Centered Therapy Date of submission: 11.09.2008 A Brief Critique of Person Centered Therapy “Existential therapy is a process of searching for the value and meaning in life” “(Corey, p. 131) with a focus on central concerns of the person’s existence; Such as death, freedom, existential isolation and meaningless. “Existential therapy can best be described as a philosophical approach that influences a counselor’s therapeutic practice” (Corey, p. 131). Founders of Existential Therapy include Soren Kagarra, Fredrich Nietzsche, Martin Heidegger and Martin Buber. They employed the humanistic approach. The contributing developers include Victor Frankl, Rollo May, Irvin Yalom, and James Bugental who developed the theory into what we have today. As one looks at the Philosophy and basic assumptions existential therapy looks at the unique characteristics that make us human and uses them as a foundation to build upon. Existential therapy also puts a great emphasis on freedom, choice, responsibility, and self determination. This student applauds that existential therapy suggests that we are the authors of our own lives. Our goal is to create meaning in our lives. There are six key propositions in existential therapy. The first is we have the capacity for self awareness, the second is because we are basically free beings we must accept the responsibility that......

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Person Centered Therapy Bohart and Watson who runs individual therapies such as, person centered therapy; can greatly assume that clients strive to develop a greater degree of independence and integration for individuals in their surroundings and the people in their lives (Corey, 2013).  Clients prepare to be open to the experience of counseling, to trust in them, to evaluate themselves internally, and to pursue willingness towards continued growth.  Fear of any of these areas requires addressing prior to moving forward with current issues, as these will impede client growth.  According to the text, clients will experience therapy differently depending on perceptions of both the past and the possibilities of future events (Corey, 2013). Exploring a wider range of beliefs and feelings aids clients during this process, helping clients to better appreciate who they are and what they are capable of accomplishing.  When clients come to counselors that they just want to talk, so they can sort out things and listen to themselves on what they are saying are on of the problems that they would have to the therapist. As a future counselor I believe that setting a topic therapy for the client is a way that can help the client to talk about how they are feeling. For instance I work at Carrier Clinic as a Mental Health Technician and right now I'm a shadowing group with the clients. And eventually as I will run group by my self one of my topics would be, for the client to pick a seashell that is in a......

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Cognitive Behavioral Therapy and Person Centered Therapy

...Applying an Integrated Approach to a Case Example: Cognitive Behavioral Therapy and Person Centered Therapy Applying an Intergraded Approach to a Case Example: Cognitive Behavioral Therapy and Person Centered Therapy Theory plays an important role in the process and outcome of therapy. For this reason, it is a topic that is examined in depth in human service education programs and research. Theory is used to explain client problems and to dictate what is done in the counseling process (Hackney, 1992). Theory can be used to define “the nature of the relationship between the counselor and client, to conceptualize the nature of the presenting problem(s), and to define the resulting counseling goals or desired outcomes” (p.2). In the past, much focus has been paid on delineating and accentuating the differences between the many theories of therapy (Sprenkle, 2003, p. 93). Today, there is a move towards convergence of theories within the helping practices (Hackney, 1992, p. 3; Sprenkle, 2003). Researchers and practitioners are searching for an integrated approach which emphasizes the key components within the helping process and relationship that have been linked to effective therapy (Hackney, 1992, p.2). Cognitive-behavioral therapy (CBT) and Person-Centered Therapy (PCT) have been shown to bring about positive changes in therapy. CBT and PCT, like all single-theory approaches, have limitations. Literature suggests......

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Person Centered Therapy

...“Evaluate the claim that Person-Centred Therapy offers the therapist is all that he / she will need to treat clients” In order to evaluate the claim that Person-Centred Therapy is all that is needed for a therapist to treat their clients, it is first necessary to look at the Therapy as a concept and the basic premise on which its theories rest, before looking at how this model effects change in the client, and then considering whether this approach is enough to achieve results in all types of client problems or whether indeed it is found to be somewhat lacking in its effectiveness for some or all cases along with some criticisms voiced by other writers and therapists who follow alternative models as a preference. . The Person-Centred or “Rogerian” model as it is sometimes referred to, was developed by an American, Carl Rogers (Jan 8 1902 – Feb 4 1987) who was one of the most influential psychologists of the 20th century. He was a humanist thinker and believed that all people are fundamentally good. He also believed that people have a self actualising tendency, or a desire to fulfil their own potential and become the best people they can be. He worked as a psychotherapist for most of his adult life and in developing his model he made some key assumptions. He believed that all individuals are capable of exercising free will and that human beings are basically good and if given the opportunity they will always strive towards......

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Gestalt Therapy vs. Person-Centered Therapy

...Person centered and Gestalt Therapy The Gestalt approach to therapy emerged during the 1950’s and was developed by Frederick Perls (1893-1970). The aim of Gestalt therapy is to increase awareness, so that the client comes to resolution of unfinished business and the integration of the thinking, feeling and sensing processes. In Gestalt therapy the emphasis is placed on the present experience, the perception of the individual as a whole and the direct awareness of emotions and action. Gestalt therapists believe that the emotional problems and frustrations that are experienced by individuals are attributed to the lack of recognition and understanding of their own feelings. In addition to this Gestaltist believe that many individuals lose parts of themselves when they are confronted with the overpowering task of coping in society.  The role of therapist in Gestalt therapy is to encourage the client to acknowledge their emotions. This is by the therapist supporting the client to express their current feeling and experiences. The main focus for the client in Gestalt therapy is to stay in the ‘here and now.’ This is very important because it allows client to stay focused in the present when it comes to their feelings and experiences. Looking at past situations, experiences and future goals is not permitted in therapy because it can cause anxieties that bring forth excessive problems. This is why the ‘here and now’ is emphasized. Also within gestalt therapy the therapist helps the...

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Client Centered Therapy

...2015 Annotated Bibliography Sanyal, N. (2011). Client-Centered Therapy: The Interior Decorator of Mind. Amity Journal Of Applied Psychology, 2(1), 49-53 . Client Centered Therapy, and those how practice it are sometimes referred to as Rogerian. This is due to the creator’s name, Carl Rogers. Of the several therapeutic systems, Client Centered therapy is known for utilizing a client’s quality elements, more than any other. This article suggests that the client can organize these elements in a kairotic fashion. Doing this helps them build and stabilize a quality of life, gaining confidence and self esteem. This study supposes that an impulse to decorate the interior of our homes may be a way to deflect other peoples supposed superiority, and diminish our deficiencies as we see them. We make it seem as though we do this to bring ourselves joy, but it really is to cover for our blazing insecurity, or as a way to show control over the space around us. This article also discusses interior design in another aspect. This is the belief that some spaces have the ability to foster personaland emotional growth, or diminish it. I am fond of this therapeutic system because as I see it Client Centered therapy is an art and a science. The success is reliant on the therapist optimizing proper climate, conditions, and relation to be successful. The role the therapist, as the listener, takes, is to to reiterate the clients statements, pointing out meaning as the session goes......

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Compare and Contrast Gestalt Therapy and Person Centred Therapy

...estalt Therapy Gestalt therapy is a form of psychotherapy that relates to the process of human perception and works on a basic concept of the Gestalt approach «The whole is different from the sum of its parts.» This approach in Gestalt psychotherapy describes the process of perception in addition to the psychic equipment in general. The Gestalt approach originated from research that was initiated by psychologists specializing in human perception which demonstrated that humans do not recognize objects as separate elements and instead organize the objects into significant totalities via the process of perception. The concept of Gestalt psychotherapy was then formally developed by Fritz Perlsduring the 1950s, a well known psychiatrist and psychotherapist that initiated an entirely new approach to psychotherapy. The name «Gestalt» means «form» and is derived from Hans-Jurgen Walter's «Gestalt Theory Psychotherapy» which is based on Gestalt psychology. Gestalt psychology relates to the interconnection of the individual and the increase in awareness where the individual's senses and behaviors merge together. Gestalt therapywas created to help individuals with problem solving. Fritz Perls noticed that the concept of individualism was a positive one but there was also a reverse side to this theory. The people who were looking for the answer to their hopes and dreams looked to Gestalt therapy as the answer which eventually became a weak point in the methodology. He added that for a...

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Gestalt Therapy with Children and a Comparative Therapy

...Introduction Gestalt therapy, which was founded by Fritz and Laura Perls in the 1940s, teaches the therapists and their clients the phenomenological awareness method, where feeling, perceiving and acting are differentiated from interpreting and rearranging the pre-existing attitudes. Gestalt therapists and clients’ dialogue, thus communicating their phenomenological perspectives, and their differences in perceptions form the basis and focus of experimentation and continued dialogue. The desired outcome of the therapy process is for the client to become aware of their actions, how they are acting, and the ways they can change their actions and learn to accept and appreciate themselves. Here, the emphasis is mainly on the process rather than the content of the therapy, that is, what is happening rather than what is being discussed. Gestalt therapy was mainly considered for adults. However, Violet Oaklander (2007) says that it is also suitable to be applied to children since it involves the body and the senses, all of which fit the therapeutic works with the children. The purpose of this paper is to formulate a response in the manner a Gestalt therapist would work with children of ages between 4 and 12. Here, the general and Gestalt literature is explored, synthesized and evaluated on working with this particular population, their specific needs and particular ethical challenges that may emerge while working with them. A comparison is offered on how different modalities with......

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Gestalt Therapy in Practice

...Gestalt therapy, although looked upon rather suspiciously by many people, grows ever more popular and widespread over time, and begins to be well-known to people who are generally very far from the problems of psychology. Here is the exemplary account of one of cases when it helped a person to develop her inner potentials and make a decision that changed her life. A woman in question, for the purposes of convenience let’s call her Jenny, moved to the new place of residence in another town and only managed to get a job of boiler-house employee, because there were not much job opportunities for outsiders. After a while, she entered a course of Gestalt therapy, which was formed along the following pattern. All the participants of this group therapy in turn communicated with the psychologist who directed the course, and we told to form images of two living beings: the one that they liked and the one they disliked. Jenny liked “the fox” (for being cunning, brave and active) and disliked “the hen” (for being passive, silly and inert). The idea of the therapy is that the liked image is what the person wants to become, while the disliked one – what she is. Over the course of communication with the psychologist, the patient and the whole group come to a decision how close the patient is to his or her desired image. In two subsequent sessions the patient imagines herself to be what she likes and what she dislikes in turn; in the course of this study, the patient together with the...

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What Is Gestalt Therapy

...What is Gestalt Therapy? Gestalt therapy is a type of therapy used to deepen our awareness of ourselves and our feelings in a less intellectual manner than the more traditional forms of therapy.  "Gestalt" means the whole; it implies wholeness.  In any experience or interaction there are feelings in the foreground and in the background.  The idea in Gestalt therapy is that all of us have had to repress or supress aspects of ourselves because they were not accepted or supported.  It is these aspects of ourselves or our feelings that end up in the background and can become unfinished business.  Gestalt therapy can help shed light on unfinished business by helping us to focus our awareness on our feelings (or lack of feelings) moment to moment.  Once we recognize our unfinished business,( i.e. uncomfortable feelings, stuck patterns of behavior, or ways in which we perceive ourselves and others that  are based on our experiences as opposed to reality), we are better equipped to understand ourselves and to choose whether we want to make changes or not.  [pic] One method utilized in Gestalt therapy is the empty-chair technique.  This is a simple tool in self-exploration and is clearly explained in an excerpt taken from the Internet. When you go see a Gestalt therapist, the office will usually have an extra chair--an empty chair.  This chair serves an important function.  The therapist may ask you to imagine holding...

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