Psychoeducational Sequelae of Chronic Otitis Media

Abstract

Learning disabilities are a multifaceted problem that is being intensively studied by numerous disciplines. Professionals involved in the diagnosis and treatment of the learning-disabled child can appreciate the often chaotic array of terminologies and classifications used to describe these enigmatic disorders. Numerous descriptive labels reflect etiological concepts based on neurological deficit theories, perceptual handicaps, delayed maturation, developmental dyslexia, emotional disorders, and teacher disability. This variability in definition and identification methods has led to a multitude of treatment procedures, many of which have questionable success. Little attention has been paid to the prevention of what are predominantly language-based disorders. In a very large percentage of children with disorders in learning, a disruption has occurred in the child's basic communication skills. Language function, especially receptive elements, have been disrupted. The child's ability to understand verbal instruction is oftentimes limited, and the visual language of reading is disrupted to a significant degree. It is also common for learning-disabled children to show dysfunction in auditory memory skills. Despite the confusion in terminology, one fact remains clear: the child in educational jeopardy is at an extreme disadvantage in a culture that places a high value on achievement and rewards those who are successful in that endeavor. Estimates of the incidence of learning disabilities in the United States range from 5 to 20%. Although these estimates vary in terms of the criteria used to identify the learning-disabled child, there is general agreement that literally millions of children are in educational jeopardy due to problems in learning. Of even greater significance is the fact that educational problems often begin at a very critical point in the child's emotional development. At approximately 5 years of age, the child begins to achieve a level of independent functioning and role definition that enables him to formulate the basic structure of his personality. The stresses of this age have been well documented by numerous personality theorists who caution that considerable emotional damage and turmoil can be precipitated by overtly stressful conflicts. One such conflict may result from failure in school. A particularly common, although very disruptive, type of learning disorder is the auditory processing deficit. Central auditory processing disturbances, included under the category of specific learning disabilities, include impairments of auditory attention, sequential memory, discrimination, sound blending, and closure skills. Although the child's cognitive functions remain intact, the processing of auditory input is deficient. Frequently, disturbances in central auditory processing interfere with the ability to develop reading, spell-