**4.4 Limitations and future directions**

Although our tests thus seem to have brought out some differences in performance between ADHD patients and dyslexics, there are obviously a number of issues that are left unresolved. For example, dyslexics' writing performance seemed not to be affected either by phonological complexity or by orthographical complexity. This leaves open the possibility that there are factors other than the above two factors that need to be taken into account, or that the sample size in this study was too small to allow us to detect an effect that is really there.

One purpose of our study was to facilitate intervention for children with ADHD or dyslexia by investigating the nature and magnitude of the learning problems faced by each group of children. The above results arguably have some implications in this regard. For instance, since children with ADHD were found to have difficulty in writing Chinese characters consisting of many strokes, it will probably be advisable, when we teach such children, to show them explicitly how to break visually complex characters into simpler components.

There are some limitations to this study that affect the generalizability of our results. First, the number of children at each grade was limited and consequently we could not ascertain the results using statistical tests. The use of our achievement tests in large groups of patients with developmental disorders in the future is likely to provide stronger evidence and further insight into the nature of learning problems among children with ADHD and dyslexia. Likewise, it will be possible to test the implications of this research more thoroughly if a longitudinal examination of children with developmental disorders is conducted.

Second, the control group was not a reading-level-matched group, but merely an agematched group with similar socioeconomic status. In order to mitigate the adverse effect of this limitation, we used material which includes only those Chinese characters that the children had learned at school more than a year prior to the experiment, so that we could ensure that the material would not be too difficult even for children with language-related problems, since some previous research has suggested that children with language-related problems may be delayed by as much as two years in a wide range of skills ((Kolb and Whishaw 2008; Wright and Zecker 2004) among others). However, future replications should use a reading-level-matched control group, as the failure to use such a control group in this study may have inflated the group difference between the children with developmental disorders and the typically developing children.

Nevertheless, in light of the fact that each condition affected some individuals in the same diagnostic groups similarly in comparison with the typically developing children, we

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believe that the results of this initial, exploratory study do give us some indication as to the types of learning problems caused by ADHD and dyslexia.

#### **5. Conclusion**

The result of our work suggests that children with dyslexia and children with ADHD have problems mainly with the phonological processing (i.e. conversion between characters and their sounds) and the orthographical processing respectively. Moreover, the fact that the achievement tests allowed us (if not in a statistically significant way at the moment) to discover differences between the two groups of children suggests that our achievement tests are successful in assessing some aspects of each child's cognitive profile and that it can therefore be useful in determining whether and what type of intervention is needed for each child.

#### **6. Acknowledgments**

We thank all the participants and staff members who supported this research project and Dr. Yosuke Kita for his helpful comments and suggestions on the earlier version of this manuscript. This research was partially supported by the Ministry of Education, Culture, Science, Sports Science and Technology Japan, Grant-in-Aid for Young Scientists (B) 2009- 21700150 to the first author and by the Ministry of Education, Culture, Science, Sports Science and Technology Japan, Grant-in-Aid for Scientific Research (B) 2008-20300281 and by the Intramural Research Grant (22-6; Clinical Research for Diagnostic and Therapeutic Innovations in Developmental Disorders) for Neurological and Psychiatric Disorders of National Center of Neurology and Psychiatry to the fifth author.

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The result of our work suggests that children with dyslexia and children with ADHD have problems mainly with the phonological processing (i.e. conversion between characters and their sounds) and the orthographical processing respectively. Moreover, the fact that the achievement tests allowed us (if not in a statistically significant way at the moment) to discover differences between the two groups of children suggests that our achievement tests are successful in assessing some aspects of each child's cognitive profile and that it can therefore be useful in determining whether and what type of intervention is needed for each

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**5. Conclusion** 

**6. Acknowledgments** 

**7. References** 

child.


**6** 

**Interventions in** 

*University of León* 

*Spain* 

**Specific Learning Disabilities Through Families** 

Specific learning disabilities (LD) are a heterogeneous group of disorders that are manifested through significant difficulties in verbal expression-comprehension, reading, writing and mathematical reasoning and ability, and presumably stem from a dysfunction of the central nervous system (Lerner & Kline, 2006). The internationally established diagnostic criteria specify a delay of at least two years and two standard deviations below the mean performance on the skill value against the normative reference group. They also establish the subject must have a normal intellectual capacity and not suffer any associated developmental disorders that could account for her/his limitations or difficulties. Lastly, the subject must also have received adequate and normal schooling (American Psychiatric Association, APA, 2002; National Joint Committee of Learning Disabilities – NJCLD 1997). However, while these conditions are essentially conceptual and define LD as intrinsic to the individual and with a biological-genetic basis, they can coexist with problems in selfregulatory behaviors, social perception and interaction. They can also exist together with other disabilities, such as sensory impairment, mental retardation, severe emotional disorders or with extrinsic factors such as cultural differences or inadequate schooling. These factors, while not the cause of the LD, can influence its course (Individuals with Disabilities Education Improvement Act – IDEA 2004. Public Law 108-446; NJCLD 1997).

If we focus on the latter perspective, which focuses on the environmental aspects, there is a proliferation of ecological models and, within them, it is common to find research tendencies that analyze the influence the specific people that make up the context for the pupil's development and difficulties (Jiménez & Rodríguez, 2008; Montiel, Montiel, & Peña, 2005; Pheula, Rohde, & Schmitz, 2011; Snowling, Muter, & Carroll, 2007; Shur-Fen, 2007). Current psychoeducational research is increasingly focusing on the contextual aspects of the factors that determine children's academic performance, studying the interrelation of the

Several studies have focused on the mutual influence of the family of the child's difficulties. Some of the studies have pointed out that resilience and protection are a result of personal variables of the pupil and LD and the environment in which s/he develops, essentially the family. It is therefore to be expected that a family environment which provides emotional support, care and stimuli for the child with LD will promote her/his development, the opposite being true for disadvantaged environments (Alomar, 2006; Barkauskiene, 2009;

pupil's personal variables and those of her/his socioemotional context.

**1. Introduction** 

Patricia Robledo-Ramón and Jesús-Nicasio García-Sánchez

