**2. Different types of learning disabilities in Malaysia**

In Malaysia, the term learning disabilities is more commonly used than the term specific learning disabilities [3]. One of the common types of learning disabilities among children in Malaysia is dyslexia. The Ministry of Education Malaysia, through its Special Education Division, defines dyslexic individuals as those with intellectual functioning equivalent to or above typical students of similar age but who have significant difficulty in spelling, reading and writing [13]. These children typically have poorer than expected academic achievement, generally 2 years behind their peers without such disabilities. Dyslexia is a type of neurodevelopmental disorder that affect basic literacy-related skills, especially spelling and reading. Dyslexia is easily recognizable once children start their formal schooling. Among the clear indicators of dyslexic children is they usually have significant reading, spelling and writing difficulties. When they write an alphabet letter, they usually write it in reverse order. Some dyslexic children spell backwards or miss an alphabet in their spelling out of their consciousness. Dyslexia is said to be due to a problem in phonological processing, which refers to the skill or ability to identify speech sounds and relate them to letters and words. Being able to distinguish the sound of letters and relating the sound to letters and words is one of the fundamental skills in language acquisition and comprehension. Dyslexic children, on the other hand, struggle to process the sound of letters and to attach meaning to both spoken and written language. Dyslexia can be comorbid, which means it can occur in combination with other types of neurodevelopmental disorders such as Autism Spectrum Disorder (ASD). Dyslexia is enormously varied and presents differently in every person. There are those who face problems

with decoding words for reading, while others have no problem with decoding, but comprehension is severely affected. Dyslexic children usually show no obvious defect in intelligence and have no impairments in hearing and sight.

It was reported that to date, there are no accurate statistics on the total number of children with dyslexia in Malaysia. However, according to the Ministry of Health portal (MyHealth) [14], it is estimated that between 4 and 8% of school-aged children in Malaysia have dyslexia. It was reported in a local newspaper [15] that Malaysia is in dire need of a broader education system and more awareness programmes for dyslexic children to avoid being misdiagnosed with other health conditions. According to the Dyslexia Malaysia Association, knowledge of dyslexia is still lacking among parents.

There have been some attempts to mitigate the dyslexia problem among school-going children in Malaysia. For example, the Special Education Division of the Ministry of Education [13] has developed a screening instrument known as Instrumen Senarai Semak Disleksia (Dyslexia Checklist Instrument). This is a local instrument that is used to screen students at the entry level of the primary schools suspected to have dyslexia and those who are at risk of having dyslexia. Those who are identified as probably having dyslexia are further referred to the medical or healthcare services for proper diagnosis. In addition, in 2010, the Ministry of Education Malaysia introduced the Literacy and Numeracy Screening programme (LINUS) [16], which is a programme developed for primary school children that focuses on ensuring each child masters their basic literacy and numeracy skills after following the first 3-year of primary education. Those who struggle with basic reading and writing skills at the entry level are placed in the LINUS programme. This is a type of intervention programme designed in remedial classes to give remedial to students' basic reading, writing and arithmetic problems.

Another type of learning disability is dyscalculia. In Malaysia, dyscalculia is not as well known as dyslexia. According to Fu and Chin [17] as cited in Aquil and Mohd Ariffin [18] knowledge of dyscalculia as well as awareness of the problem is still not widespread in Malaysia. The prevalence rate is also not known as there is very limited research evidence on the prevalence of dyscalculia in the whole of Malaysia [18]. Dyscalculia generally refers to the problem affecting the ability to comprehend the concept of numbers and to acquire arithmetic skills [19]. Children with dyscalculia usually have deficits in counting and calculating at many math levels, which are fundamental in mathematical acquisition, reasoning and knowledge. They are struggling with basic mathematical operation such as counting quantities, addition, multiplication, segregating the smaller or bigger numbers, etc. While dyslexia is a problem specific to spelling and writing, dyscalculia is a type of learning disability specifically affecting children' ability to understand and work with numbers. Some early signs of dyscalculia, as listed by Plerou [19], are the inability to memorize number sequence, difficulties in basic number counting, difficulties in number comparison and difficulties in connecting numbers to symbols (e.g., 3 = three).

The possible causes for dyscalculia are not fully understood, but research suggests some biological factors such as genetic factors and differences in brain structures responsible for processing numbers and mathematical concepts in individuals with dyscalculia [20]. Dyscalculia may happen in association with other types of learning disability such as Dyslexia and Dysgraphia. Children who have dyscalculia may continue to struggle as adults if no intervention is given to manage the difficulty. Despite the lack of knowledge and misconception of the problem with dyscalculia in Malaysia, efforts have been made to improve its identification and diagnosis to provide support for children with this type of learning disability. Currently, in Malaysia,

#### *Children with Learning Disabilities in Malaysia DOI: http://dx.doi.org/10.5772/intechopen.113230*

a standardized instrument that can be used in the diagnosis of dyscalculia is still lacking [21]. However, there have been some initiatives to develop local instruments that can be used as early identification system for dyscalculia. For example, Malaysian Dyscalculia Instrument Plus was developed as dyscalculia screener and CheckDysc©, which has been found to be able to provide early detection that can alert parents and teachers on the risk for dyscalculia in children [22]. As regard remedial measures for dyscalculia children, the use of mobile app learning has shown some positive effect of math learning. A study conducted by Ariffin et al. [23] reported that dyscalculia children have shown improvement in math learning following a mobile app learning named "Calculic Kids." Another local researcher [24] proposed "*i-Matematik"* in web-based courseware to teach mathematics to students who face difficulties with mathematics.

Dysgraphia is another type of learning disability that primarily affects another fundamental literacy skill: writing. Children with dysgraphia face significant difficulty in writing with clarity and accuracy. They face problems in skills to hand write, to spell words and to organize their thoughts on paper. Specifically, a form of dysgraphia known as motor dysgraphia is due to deficient fine motor skills that limit the children to produce legible handwriting. They are found to have awkward pencil grip and unspecified motor clumsiness [25]. In addition to significantly producing spelling mistakes when writing, they also experience challenges in forming or writing letters and words. Those with language-based or cognitive-based dysgraphia have trouble translating thoughts and ideas into written expression. As with other types of learning disabilities, dysgraphia can come in conjunction with dyslexia and dyscalculia as well as other pervasive developmental problems such as ASD and ADHD. Not much data on dysgraphia in Malaysia is available as very limited research on this problem is conducted. As awareness and knowledge about dysgraphia among the Malaysian community is very scarce, children with dysgraphia are sometimes misidentified as dyslexic. Based on the report from the Malaysian Welfare Department [26], children with dysgraphia also include those with dyslexia. To help children with dysgraphia a study conducted by [25] designed a dysgraphic-customized application called Write-Rite to support children with dysgraphia, which has been found to produce a positive effect on the children's handwriting performance.

Dyslexia, dyscalculia and dysgraphia represent significant impairments to a particular aspect of academic learning such as reading, calculating and writing. Two additional major disorders frequently linked to learning difficulties are Autism Spectrum Disorder (ASD) and Attention-Deficit Hyperactive Disorder (ADHD). ASD is a pervasive developmental disorder affecting an individual's social, communicative and language skills [27]. Ranging from mild to severe, children with ASD generally have cognitive disabilities that implicate their learning, memory ability and emotions [28]. The DSM 5 characterized those with ASD by their persistent impairment in social interaction and social communication skills such as deficits in social-emotional reciprocity as well as restricted and repetitive patterns of behaviors, activities or interests manifested by stereotyped motor movements and others. Children with ASD may appear passive because they are equally unable to use non-verbal communication. This harbors frustration, leading them to express themselves through tantrums, aggression or other inappropriate behaviours. Currently in Malaysia, no official number of ASD children can be found in the registry [29]. Part of the reason is that ASD cases are lumped together under the category of learning disabilities and other cognitive and developmental abilities [30]. The Ministry of Health Malaysia reported that ASD cases are on the rise, and they are detected mostly during early childhood

when children are already in school. Since there is no cure for ASD, early diagnosis and treatment can help improve the development of the child [2].

Another major disorder associated closely with learning disabilities is Attention-Deficit Hyperactive Disorder (ADHD). It is one of the most common neurodevelopmental disorders affecting an estimated 8–10% of school children [31]. The core symptoms of ADHD, as prescribed by DSM 5, are a persistent pattern of inattention and/or hyperactive and impulsive behavior that is more frequent and severe than is typically seen in a child at a given developmental stage and has caused significant functional impairment [32]. Their behavioural and emotional problems present a serious obstacle to the academic, social and emotional development of children with ADHD and negatively affect their adjustment to adult life. Generally, children diagnosed with ADHD will face problems with their ability to focus as they are very easily distracted and often lose concentration. Their impulsiveness and motor activity levels also present significant challenges in school settings. As reported in Ref. [32], the estimated prevalence of ADHD in Malaysia ranges from 1.6 to 4.6%, and boys are three to four times more likely to be diagnosed with ADHD than girls. Contributing factors to ADHD include both genetic and environmental factors such as traumatic brain injury and some prenatal factors. The Malaysian clinical practice guidelines prescribe that any child presenting with difficulties in academic have behavioral problems and mood disturbances should be evaluated for ADHD to prevent deleterious outcomes in adulthood [32].

### **3. Discussion and way forward**

The children of the nation are assets, so education is essential. As cited in Ref. [33], several declarations of the United Nations such as the Convention on the Rights of the Child, Convention on the Rights of Persons with Disabilities, and the Universal Declaration of Human Rights have explicitly stated the right for education to everyone including those with learning disabilities. It was further reported that in Malaysia, the educational rights for children with learning disabilities have been specifically provided under Section 28 of the Persons with Disabilities Act 2008, which states that children with learning disabilities should not be excluded from the general education system on the basis of their disabilities. Thus, regardless of their disabilities, an equal access to education must be granted to them.

Various initiatives have been taken by the Malaysian government to confer educational rights for children with learning disabilities. Among the positive steps taken by the Ministry of Education, through its Special Education Division are to make available special education programme for those with special needs. Under this programme, special schools for students with visual and hearing impairments as well as those with learning disabilities are developed. In addition, the special education integration programme places students with special needs in special classes in mainstream schools while in the inclusive education programme, children with special needs learn the same curriculum and are placed in the same class as normal students. The effort in preparing LINUS screening and intervention programmes is indeed a positive step toward the early identification of students with learning disabilities in Malaysia. These are among the initiatives taken by the government to ensure children with different types of disabilities have equal education opportunities as other normal children. As reported in Ref. [33], according to the 2021 report by the Ministry of Education, there are 97,220 students enrolled on the special education programme.

#### *Children with Learning Disabilities in Malaysia DOI: http://dx.doi.org/10.5772/intechopen.113230*

As described above, learning disabilities may be manifested differently in children and are usually detected or become apparent when they start formal education. If left unattended, issues related to learning disabilities can have negative effects, among others, on the children's self-esteem and motivation to learn. Numerous studies have found a sizeable percentage of delinquents, school dropouts, and those involved in drug abuse and crime have some form of learning disabilities [34]. In addition to having full rights to education, children with learning disabilities can succeed and can benefit the most from their education if the following challenges and issues can be attended to and resolved by the authorities.

The first unresolved issue concerns the problem of identifying and classifying those with learning disabilities. As was previously stated, there are varieties of problems that can hinder learning. Some like dyslexia, dyscalculia and dysgraphia have an impact on only certain aspects of literacy skills such as reading, calculating and writing, respectively, while others are more widespread and co-occur with other forms of pervasive developmental disorders such as ASD and ADHD. This misidentification and misclassification issues could be due to the use of the broad generic term to refer to persons with learning disabilities [3]. Currently, in Malaysia, there is still no agreement on the accurate definition to define or identify individuals with learning disabilities. Instead, a very broad and heterogeneous definition is used to describe anyone identified with problems in learning. There are also no standardized criteria to identify those with learning disabilities. While efforts have been taken to provide special education schools for those with learning disabilities, these special schools accommodate students not only those with learning disabilities but also those with Down Syndrome, ASD, ADHD, Dyslexia, Slow Learner and Mental Retarded [33]. This means those who are identified with various sorts of learning problems are lumped into one category. As such, their unique learning characteristics and differences are mixed up or are not attended to and ignored. This inaccurate identification and misclassification of individuals with learning disabilities implies that ensuring adequate support and services to suit each sub-group within the current broadly defined learning disabilities is impossible. This is something that needs to be rectified because every child with a learning disability might have different needs and require specific attention.

It is, therefore, crucial to accurately understand and describe the likely character, behavior and cognitive ability of children with different forms of learning disabilities. The different behavioral and psychological manifestations of learning disabilities in children warrant for a development of a comprehensive profile in which the most important characteristics and psychological patterns of children with learning disabilities can be identified and compiled. As typically learning disabilities are closely associated with cognitive deficits, comprehensive cognitive profiling is highly recommended to be developed to help with the understanding of the children's needs in learning and subsequently mitigate their negative effects as these children are indeed capable of learning. All these should start by having a standardized and accurate definition of learning disabilities to ensure adequate assessment, intervention and research on the problems and needs of this group is available.

The second pertinent issue is the need for accurate diagnosis of children with learning disabilities. Currently, in Malaysia, there is a lack of standardized assessment tools that are locally and culturally sensitive to detect and diagnose individuals at risk for learning disabilities [18]. Research emphasizes the need for effective screening and diagnostic systems to identify developmental disorders at the earliest possible stage, clearly indicating that the chances of overcoming difficulties are significantly

enhanced by early identification [1]. The use of standardized tools to identify any potential developmental and learning problems at the early stage of the developmental phase is highly recommended because it could provide adequate and appropriate intervention to minimize the disability. Equally important is the awareness of the parents or caretakers on the importance of assessing their child following any potential symptoms for learning disabilities. A better analysis of the needs of children with learning disabilities that will allow for effective policy formulation and programme implementation must be established as currently, in Malaysia, there is a scarcity of valid and reliable data employing psychological assessment instruments to identify and characterize several neurodevelopmental disorders that hinder children from their full potential of learning.

Given that learning disabilities usually involve more than a single disorder, it also becomes essential to develop a psychological profile of Malaysian children with learning disabilities that will become the foundation on which to plan for educational support for the different kinds of learning disabilities. Over the years, there have been calls to establish a comprehensive profile to provide relevant authorities and policymakers, teachers, as well as parents, with specific information that can be used to develop a framework for personalized learning experiences to suit children's disabilities. Specifically, as much of learning disability problems are related to their cognitive functioning, a cognitive profile of children with learning disabilities must be developed. It is through this profile that the strengths as well as limitations related to their learning abilities can be identified. Based on the strengths and limitations found, a differentiated learning framework can be implemented to suit the learning needs of the children with learning disabilities. Given the dearth of research in this area in the Malaysian context and the paucity of data on learning difficulties, there is an urgent need for research to develop a cognitive profile for Malaysian children with learning disabilities in their preschool years, to allow for every child to have a programme tailored to his unique profile.

Early identification and intervention are vital to lessen the learning difficulties experienced by children with learning disabilities. They might learn differently from their normal counterparts and are capable of succeeding and can benefit the most from their education if their latent learning attributes are made explicit. As symptoms for learning disabilities become apparent early in the developmental period, assessment and identification should start early, preferably at preschool entrance stage as understanding the need and strategies for intervention must be given as soon as the disability becomes apparent, whether in kindergarten or elementary schools. Research has strongly supported the fact that early detection and intervention offer better longterm outcomes. Early identification of children who may be at risk of having specific learning disabilities is crucial to assist them in overcoming barriers to learning. As a consequence, this will help to prevent the growth of children with academic failure, lower motivation, greater frustration, distress, school dropout and peer rejection [34].

Lastly, there is a need for professional development of teachers and educators in Malaysia to understand better and address the needs of children with learning disabilities. More research on this area is needed, and parental awareness and involvement are also expected to create a more inclusive learning environment for these children. Parents are encouraged to actively participate in their child's education. They can work with teachers and educational specialists to develop strategies and plans to support their child's learning needs. Other relevant professionals such as child psychiatrists, pediatricians, child neurologists, clinical psychologists, educational psychologists and cognitive psychologists who are

necessary for the identification, assessment, evaluation and development of intervention of children with learning disabilities should also be increased as to date, in Malaysia, their number is still limited [3].
