Diagnosing LD

Learning Disabilities Aren’t Just for Kids

It may not be ADHD that makes reading, writing, or math difficult — a learning disability can be a lifelong issue, and often goes undetected. Read on for advice on how to diagnose, treat, and overcome an LD.

It may not be ADHD that causes your struggle with reading, writing, or math. Learning disabilities aren't just for kids — they can be a lifelong issue.
It may not be ADHD that causes your struggle with reading, writing, or math. Learning disabilities aren't just for kids — they can be a lifelong issue.

Shortly before my ADHD diagnosis, at age 47, I’d gone back to school for a degree in adult education. As I got to know my fellow students, I realized that, unlike myself, they were married, had kids, and were full-time professionals. While they seemed to stand up to the pressure, I struggled to keep up with assigned readings, and my self-employment suffered as I focused on schoolwork. It dawned on me that something was wrong.

I did manage to graduate. Soon after, I was diagnosed with ADHD. I wondered if that was the source of my academic challenges. I took medication and did mindfulness training, and I was able to manage time better, focus more, and stay better organized. But seven years later, I’m still a slow reader, and I am less productive than I’d like to be. Then I discovered that up to 50 percent of adults with ADHD also have a learning disability (LD).

If, like me, you’re an adult diagnosed with ADHD who has optimized your ADHD treatment plan, but you are still struggling at work or in grad school with reading or math, it may be time to be evaluated for LD. In Taking Charge of Adult ADHD, Russell Barkley, Ph.D., points out that, like ADHD, LD hampers social relationships, workplace performance, and your self-esteem. Here’s what I learned about LD and ADHD in my quest to manage my own challenges.

A learning disability is a neurological disorder. In simple terms, it results from a difference in the way a person’s brain is “wired.” Adults and children with learning disabilities are as smart or smarter than their peers, but they have difficulty reading, writing, spelling, reasoning, recalling and/or organizing information if left to figure things out by themselves or if taught in conventional ways.

Like ADHD, an LD can’t be cured or fixed; it is a lifelong issue. With the right support and intervention, however, adults with learning disabilities can go on to have successful careers. Many adults first notice their learning disabilities in college. Your natural abilities may have allowed you to compensate for your learning disability in high school, but coping strategies may not work for you in college, with its large class sizes, heavy workload, and fast-paced lectures.

Dan Perdue, 34, noticed that his LD — the language-based disability called dyslexia, which hinders a person’s understanding of written words — worsens in some situations. “If the environment isn’t supportive, everything becomes more difficult to do. Reading is harder, spelling is harder, math is harder. The more pressure I feel to get it right, the harder it is to get it right,” he says. Perdue was diagnosed with ADHD at 30, but he’s known about his dyslexia since second grade. He is a slow reader who transposes numbers and words.

Because of his challenges in public school, Perdue says he became a perfectionist; he didn’t try if there was a chance of failure. “If I didn’t try, I didn’t fail. My LD lowered my self-esteem and my self-worth, because I assumed I’d never be able to get it right anyway.”

Perdue was luckier than most, though. After finding out that his second-grade teacher thought he wasn’t trying, or was incapable of doing the work, Perdue’s mother read extensively about dyslexia and started homeschooling him. She also hired a tutor, who specialized in teaching kids with dyslexia, to work with her son.

Perdue and his mother decided that he would go to public high school because he wanted more interaction with his peers. Before entering his freshman year, he had his academic abilities tested. “I scored at a college level in everything, except math and spelling,” says Perdue.

Over time, Perdue did poorly in high school because of the large class sizes. He lost the ability to learn at his own pace, and became bored with the subjects he tested well in. Perdue left high school before graduating, but later went back to get his high school equivalency diploma.

Megan Bell, 27, first suspected she had a learning disability when she was six, while reading to her mother. “I memorized a book, but I memorized it through the pictures. If you covered up the pictures, I didn’t know what the book said.” Megan failed many courses in school, but the teachers advanced her anyway. Every day was a struggle for Bell, so she left school at 15.

Bell’s untreated LD has severely limited her occupational options. She waitressed for a short time, but she had trouble reading the menus quickly and calculating checks for customers. So she started dancing at 18. Bell says, “I’ve got a job that I can do and that I can make good money at. And no reading is required.”

Hadley Koltun, Ph.D., a psychologist at JVS Toronto, who assesses LDs in children, adolescents, and adults, has worked with many ADHD adults whose LD hampered their job performance. At most jobs, there’s a premium on effective reading, doing math, juggling spreadsheets, and analyzing information. “If you’re having difficulties with those things, and they’re connected with learning challenges, you need to look into an evaluation for LD before you’re fired.”

Todd Cunningham, Ph.D., a clinical psychologist and consultant in Toronto, Ontario, says that remediation isn’t usually an option for adults diagnosed with LD. It takes too long to achieve measurable success. Says Cunningham: “Starting with teenagers and into adulthood, we go with compensatory programming.” This means using a variety of assistive technologies to make up for learning deficiencies.

Software that was developed to assist LD students is popping up via GPS and smartphone apps, says Cunningham. Bell has used these to cope with her reading disability. Instead of trying to read maps, she has a friend enter her address into her GPS. “The best thing for me was texting. I want keep up with friends, so we text back and forth, and I learn words that I otherwise wouldn’t know.” Whenever she’s texting, Bell relies on her phone’s spellcheck feature. Since she’s been texting, Bell realizes she’s better at writing than she thought.

Unfortunately, like many others, Bell says she’s never gotten help for her LD. Assessment and counseling for LDs can be difficult to find, not to mention expensive. Instead of getting professional help from an LD specialist, Perdue and other adults have developed their own strategies for dealing with LD.

Ned Hallowell, M.D.‘s concept of “good enough” has helped Perdue a lot. “Good enough” means determining your own standards and personal value system, and sticking to them. When he remembers that he only has to be “good enough,” not perfect, Perdue is more successful and productive at work.

Bell found that helping her son with schoolwork helped her with her own reading challenges. “When my oldest son was in kindergarten, I would go through his books with him. Going over the basics again was surprisingly helpful.” Bell feels that poor memory, due to her ADHD, keeps her from being able to read because she can remember only so many words before being overwhelmed. “I have a conversation and I remember it; if I read it, I can’t recall it five minutes later.”

In high school, Perdue discovered that reading on colored paper was easier than reading black print on white paper. The difference was so dramatic that, when he was failing algebra quizzes and tests, he approached his teacher. “I asked if she could give me my quizzes and tests on colored paper, and she did. I went from an F to a B.”

While ADHD treatments aren’t designed to treat a learning disability, they can help in some cases. “The key thing about medication,” says Koltun, “whether it’s a stimulant or nonstimulant, is that it helps focus the individual, so that he is in a better state to learn.”

Perdue doesn’t see his LD as all bad. “Dyslexia, as does ADHD, boosts my creativity. People with dyslexia tend to be broad thinkers, and intuitive. We automatically have to do some things differently. Doing linear work [math, spelling, reading] is very difficult, so to be successful, you become intuitive.” Perdue says the intuition gained from coping with an LD helps you to assess situations and avoid those that call for skills you’re weaker at.

A positive attitude makes a big difference. “It’s important to view a disability as a difference,” says Perdue. “I can write, I can read, [but] I do it differently than most people. My ideas come to me differently, so even if it’s a challenge, we can still achieve things in our own way.”

As for me, the jury is out as to whether or not I have a learning disability. I hope to find strategies to be more productive in my career. In the process, I’ve reminded myself that it’s OK to be different. My goal is to keep learning by doing it my way.

Get to the Bottom of an LD

If you suspect you have a learning disability, follow these three steps:

1. Get assessed. Assessments are typically done by psychologists with special training in LD. Assessments can range in cost. A comprehensive, six-hour, psycho-vocational assessment costs a couple thousand dollars. It includes behavioral, social, and emotional screening and testing. The expert will evaluate the individual’s reasoning abilities, working memory, and processing speed.

2. Develop a plan. Your assessment results will lead to one of two plans of action: remediation or compensation. In children, remediation can help manage the underlying deficit, says Todd Cunningham, Ph.D., a clinical psychologist and consultant in Toronto, Ontario. For busy adults looking to improve their work performance, Cunningham uses assistive technology. Text-to-speech technology, like Voice Dream or Read&Write Gold, translates text on a computer screen into audible speech. Speech-to-text technology, like the Dragon Dictation app or Dragon NaturallySpeaking, type what you say. You can launch applications, open files, and control your mouse with your voice, all of which increases productivity. Fractional, decimal, statistical, and talking calculators can help with a math disability.

3. Work with an LD specialist to tailor assistive technology to your learning needs. People don’t always respond optimally to the voice used in text-to-speech programs or to the program itself, says Cunningham. In addition, cognitive processing speed and working memory should be taken into account to determine the best speed at which the words are read back. An expert can help find the right software, so that a person with LD gets the most out of the technology.

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