1. What are learning difficulties?

Many parents are curious about the learning difficulties clinic opened by the Children's Hospital Affiliated to Fudan University. Some people also joked: "Why don't we have another department for difficulties in going to work?" "Please open a clinic for difficulties in getting up" "If I didn't catch up with the good times, I would have become a top student earlier"...

In fact, the hospital's opening of a learning difficulties clinic is a professional choice based on medical knowledge, because learning difficulties can indeed be regarded as a medical problem.

Learning difficulties generally refer to school-age children with normal intelligence who lag behind in academic performance due to environmental, psychological or physical reasons. This concept originated from education. Later, with the development of psychiatry, psychology, and cognitive neuroscience, people have a more comprehensive understanding of learning difficulties - learning difficulties are a phenomenon or symptom, which can be manifested as incomplete abilities in language use, speaking, writing, and calculation. Behind them may be a bad mental state, a bad parent-child relationship, or a mental and psychological disorder.

Foreign data show that about 20% of children have learning difficulties during school; domestic epidemiological surveys also show that children with learning difficulties account for about 13% to 17% of school-age children. In reality, when facing the problem of children's learning difficulties, many parents either interpret this as a problem with their children's learning attitude or do not understand the reasons, so that their behavior is of no help to their children. Another point that parents need to pay attention to is that some children have learning difficulties not because of laziness or mischief, but because the children are sick. However, since many people generally ignore or even discriminate against mental and psychological problems, parents are unwilling to admit that their children have psychological problems even if they have doubts, so the situation will only get worse.

From a medical point of view, the learning difficulties clinic uses obvious "symptoms of learning difficulties" as a starting point to help improve the public's awareness and acceptance of this issue, so as to truly find the reasons for children's learning difficulties and provide targeted help and treatment.

2. There are three main reasons for poor grades

Learning is a complex activity that involves reading, understanding, writing, calculation, expression and other abilities, and is affected by many factors. The poor academic performance that is usually seen is mainly due to the following three reasons.

Realistic difficulties related to learning

Children have real difficulties such as not establishing good learning habits, wrong learning methods, being immersed in fun outside of learning, having no interest in learning, and being slow in accepting and understanding knowledge, which leads to poor grades. In view of these situations, teachers, parents and children need to cooperate with each other, analyze the specific reasons for poor grades together, and take targeted measures to help children. For example, increase children's interest in learning, help children find scientific learning methods and habits, and give specific learning guidance.

Poor campus and family environment

Children have a bad relationship with classmates at school, encounter campus bullying, and have a bad relationship with the teacher, which will cause children to resist school and learning and develop a dislike for learning. Poor academic performance will make them feel more frustrated, and then more dislike for learning, forming a vicious circle. In addition, bad family relationships may also lead to children's lack of self-confidence, poor communication skills, lack of learning motivation, poor social adaptation, and bad mood during their growth, thus affecting their academic performance.

Psychological diseases

Emotional disorders, learning disabilities, attention deficit hyperactivity disorder and other mental and psychological problems will affect children's emotions and cognitive abilities, or limit their learning ability in specific skill areas. If these diseases are not treated professionally, children's learning difficulties cannot be solved.

3. Poor learning may be caused by these diseases

Learning difficulties in medicine mainly refer to the obvious backwardness of academic performance due to obstacles in the acquisition or development of learning skills of children. This is different from poor academic performance, lack of effort in learning, and lack of love for learning in the general sense.

In other words, learning difficulties in the eyes of parents and teachers may have medical pathological causes, which are caused by diseases. From a clinical perspective, this disease includes neurodevelopmental problems, emotional and mental disorders. Neurodevelopmental problems include "learning disabilities (reading disabilities, writing disabilities, mathematical disabilities, etc.)", "attention deficit hyperactivity disorder (ADHD)", "mental retardation", "autism spectrum disorder (autism, also known as autism)", etc.; emotional and mental disorders include depression, anxiety, adaptation problems, etc.

We will focus on several common diseases that affect learning ability.

ADHD

ADHD is the most common condition in outpatient clinics. Children with ADHD are mainly characterized by easy distraction, excessive activity regardless of occasion, and emotional impulse. They are often accompanied by learning difficulties, conduct disorders, and maladjustment, but their intelligence is normal or close to normal. The prevalence of ADHD in my country is about 6.4%. This disorder makes it difficult for children to concentrate, easily distracted when doing things, often make some careless mistakes, find it difficult to listen and complete assigned tasks, move slowly, complete homework slowly, and find it difficult to calm down, which will affect their academic performance.

Learning disabilities

Although children with learning disabilities have normal intelligence, they lag behind in a certain learning ability, which affects their grades in the corresponding subjects. For example, children with reading skill disabilities will show slow reading speed, often make mistakes such as omitting, replacing, distorting or adding words and phrases when reading, cannot recall what they read, cannot draw conclusions or inferences from the reading materials, and may miss lines or reread the same line when reading aloud. Children with dyscalculia may not understand the basic concepts of a particular operation, cannot recognize mathematical symbols, have difficulty in sorting numbers correctly or inserting decimal points and symbols in operations, and have difficulty performing mathematical operations. Children with spelling disorders may miss strokes when writing.

Autism

Autism is often manifested as social defects, communication difficulties, stereotyped behavior, narrow interests, etc., and at the same time, it is obsessed with some monotonous things, which makes it difficult for children to communicate with teachers and classmates, and naturally there will be great obstacles in learning.

Mental retardation

Mental retardation refers to the individual's general intellectual function being significantly lower than that of peers during the development period (before the age of 18), accompanied by defects in adaptive behavior, which leads to learning difficulties.

Emotional disorders

Depression and anxiety can significantly reduce children's cognitive abilities, such as memory loss, inability to concentrate, slow reactions, and decreased thinking ability. At the same time, it can also make children depressed, irritable, have no interest in anything, often feel exhausted, and lack confidence, all of which will prevent children from normally investing in learning.

4. The earlier the intervention, the better the effect

If parents and teachers do not understand the symptoms of the above diseases, they are likely to misunderstand the children's various behaviors as "laziness", "bad attitude", "not liking to study", etc., and then blame and criticize the children. Children do not know that their learning difficulties may be related to the disease. After the frustration caused by the blame of parents and teachers, it will continue to affect their emotions and lose interest and motivation in learning.

After it is clear that the learning difficulties are caused by the disease, intervention measures should be taken for the corresponding psychological problems under the guidance of doctors. If it is a neurodevelopmental disorder, such as learning disabilities, attention deficit hyperactivity disorder, autism, etc., specialists need to develop personalized plans for the different conditions of children, carry out drug treatment, sensory integration training, behavior correction training, attention training, memory training and other systematic behavior training and behavior correction, as well as comprehensive interventions such as psychotherapy. If it is an emotional disorder, it is necessary to use drug treatment, psychotherapy and teach parents some mental health education knowledge to effectively help children relieve emotions and improve cognitive functions.

It is very important to detect, diagnose and intervene in learning difficulties early. Children in early childhood generally involve activities such as reading, writing, calculating, communicating with others, and abiding by certain rules. Parents should pay attention to whether their children have problems such as inattention, non-compliance with classroom discipline, easy conflicts with classmates, and difficulty in reading, writing, and calculating when doing these things. Once it is found that the child is too slow and lagging behind in some aspects compared with his peers, it is recommended to go to the hospital for professional evaluation, and do not be afraid to seek medical treatment. In addition, if kindergarten and primary school teachers can find the problems of children in time and communicate with parents, it will be of great help.

5. What else parents can do

In short, learning difficulties are superficial, and the many problems hidden behind them are more worthy of attention and attention. Parents are the guardians of their children and the guardians of their children's healthy growth. How to correctly understand learning is very important.

First, parents should be committed to establishing and creating a good parent-child relationship and family atmosphere. Learning is only a part of children's lives. Parents should not use their children's learning as a reference to measure the quality of their children or the mode of getting along with their children. An inclusive, accepting, and loving family environment helps children build self-confidence, develop better resistance to frustration, and maintain a stable mood. No matter what difficulties children face, or why they have learning difficulties or poor grades, parents should sincerely accept their children's shortcomings and have enough patience to explore the reasons for their poor grades with their children, rather than simply blaming and criticizing them.

Second, help children establish learning motivation and habits. Excessive deprivation of children's leisure and play time will make children rebellious about learning, and excessive pampering and laissez-faire are not conducive to children developing good learning habits. Therefore, parents should create a good learning environment for their children from an early age, set clear learning and leisure time, cultivate their children's reading and writing interests, stimulate their children's learning motivation through various methods, and adopt appropriate time planning and behavioral constraints to help children form learning interests and scientific learning habits and methods.

Third, help children face difficulties. Parents need to understand what learning difficulties are, distinguish whether the child's current difficulties are medical problems with learning obstacles, psychological problems of not wanting to learn, or some specific difficulties encountered in learning, and then seek help in a targeted manner to solve the problem. If the child's learning difficulties are real problems, such as not keeping up with the teaching progress of a certain subject or not understanding it, parents can seek help from teachers and give guidance; if it is a disease problem, parents should take their children to receive professional diagnosis and treatment as soon as possible; if it is a psychological problem, parents should consult a psychologist and strive to repair the child's internal discomfort. In fact, many times, facing poor academic performance, children are more anxious than parents, but they don't express it clearly. As an outpatient child said with a sad face: "I just don't want to study and can't learn. Although I know it's wrong and I feel uncomfortable, I don't know what to do. In fact, I hope my parents can tell me what I should do, but they only criticize me or keep nagging me, which can't solve the problem at all."

Fourth, give children encouraging education. Learning difficulties are a major setback for children. Parents should stabilize their emotions and face this setback with their children. In this process, it is necessary to realize that children do have relevant difficulties, and do not treat these difficulties harshly. Instead, pay attention to the progress made by children and other bright spots, and encourage and affirm them. For children receiving treatment, parents should also give positive feedback in time on their progress in rehabilitation.

Finally, I want to emphasize that parents should also learn to grow themselves. Getting along with children is actually a test of parents' emotional stability, mentality, and communication skills. Therefore, parents need to learn some emotional stability techniques and scientific communication skills with their children. The improvement of parents' own state is also a demonstration and support for their children to a certain extent, which will help children face the setbacks and difficulties in their future lives more positively.