The misdiagnosis of a learning disability (LD) can harm the self-esteem of students seeking to fit in with their peers, while those with real learning difficulties continue to struggle to get the treatment that they need.
The problems in LD diagnosis are presented in a study by Chulalongkorn University Professor of Education Dr Amornwich Nakornthap. In a development project with provincial schools, the professor and his team found something abnormal the prevalence of LD. In one of the sample schools, Dr Amornwich's team found an unusually high number of LD students relative to the national average.
According to the Ministry of Public Health's Department of Mental Health, the nationwide average figure of LD students per school falls between 2% to 10%.
However, in this school of 150 children, 30 children, or 20%, were apparently diagnosed with a LD.
However, when a clinical psychologist ran a later assessment on the school's students, it was determined that only seven children (4.7%) actually had a LD.
After the release of these findings, questions arose regarding the LD diagnosis process. As teachers are usually those who determine if a student has a LD, their eligibility to conduct such assessments swiftly came under fire.
As Dr Amornwich and his team dug deeper into the case, they found that children initially thought to have a LD were misdiagnosed due to sheer misunderstanding on the teacher's part.
Teachers tend to generalise students' cases out of a lack of knowledge when assessing learning disabilities, Dr Amornwich explained.
For example, he said, if a student shows a slower pace of learning, teachers may simply assume they have a learning disability.
Slow learning can stem from several reasons, however.
Dr Amornwich said that learning disabilities can be effectively managed when detected at an early enough age -- in this case, children stand a greater chance of catching up with their peers.
However, even if a LD is accurately diagnosed, problems can arise when parents refuse to take their children to the doctor for further evaluation, often citing fear of judgment from a society that sees a LD as taboo.
LD is a term covering a wide range of conditions affecting one's ability to learn in a "normal" manner. These include difficulty with reading (dyslexia), mathematics (dyscalculia) and writing (dysgraphia).
Without proper guidance, children with LD can easily fall behind at school.
As the government falls short of addressing such issues, Thailand continues to waste valuable human resources every year.
FIGHTING STIGMA
Learning disabilities do not stem from a lack of basic intelligence and motivation, contrary to popular belief. Students with LD are simply wired to learn differently.
LD can sometimes result from social factors like a poor upbringing, lack of parental care, domestic abuse and drug abuse during pregnancy.
Learning disabilities cannot be fully cured, but they can be managed. Managing them starts with having a proper professional assessment.
In Thai education law, LDs are listed among the nine types of disabilities that are eligible for state assistance.
However, due to a lack of social acceptance, children with LDs are often ostracised and subjected to ridicule by peers. Without proper treatment, these youth find themselves unable to keep up with peers.
Left with little support, they become outcasts and can even drop out of school.
Although systemic attempts have been made to lower the instances of LD, problems in addressing the issue persist, especially in diagnosis.
Currently, the Ministry of Education's Special Education Bureau has 172 schools to which it administers special education for LD students.
However, help for LD youth remains generally scarce.
Pitchaporn Sittichoke, a clinical psychologist who serves on Dr Amornwich's research team, said LD is a new concept to many Thais, who commonly believe that those who suffer from it are lazy and unintelligent.
She warns that this belief can have adverse effects on kids with LD.
"LD students are not handicapped," she said. "They are just different and they require a special way of learning -- ones that suits their learning style."
IN A STATE
Teachers are usually the first to draw attention to students' potential LD. If teachers at a school report a high enough number of LD kids, the state is obliged to provide them with assistants to take care of students.
However, teachers' lack of knowledge of LD means that children are often misdiagnosed with it.
Ms Pitchaporn said LD children stand a chance to improve performance at school if offered the proper care.
She explained this take place when parents, schools and healthcare professionals participate in the process.
If a LD student has problems spelling, the school can organise an individualised education plan (IEP) to better the problem at the child's own pace, she said.
The student can continue to study with their peers in other subjects.
The teacher can assign work according to the student's needs and abilities.
"It might be tiring for the teacher at first, but once the child's pace has improved and they start catching up with their peers, they can resume a normal pace," she said.
Ms Pitchaporn said some schools have already adopted this approach. These schools are usually supervised by the Special Education Bureau.
However, the schools not featured on the list may still fail to properly assess the kids and help them accordingly.
The government helps fund schools with IEPs, offering 2,000 baht per head. However, an anonymous source says the system can be taken advantage of, with some schools falsely categorising children as having LD to get more money to the school, without the purpose of creating more IEPs.
Some schools also reportedly categorise regular students with poor grades as having LD to ensure they do not get counted in O-Net (standardised national test) scores. This way, the school can keep the school's ranking high and receive other government benefits.
Dr Amornwich said the problem stems from the system, which can affect students' early socialisation. In these cases, children may start to think they have no future.
Seeing no future in academia, they can be led to turn to other distractions like drugs.
Children who are falsely diagnosed with LD may succumb to the belief that they are inadequate and that they have no future by default. Since they have no future academically, they can be led astray.
SPECIAL MEASURES
Another problem standing in the way of treating LD students is a lack of special education teachers. Dr Amornwich says there are currently only around 350 special education teachers in Thailand despite a soaring demand for such specialists.
making the grade: Chulalongkorn University's Dr Amornwich Nakornthap. PHOTO: Patpon Sabpaitoon
"Special education teachers are scarce, but so are teachers of these teachers," he said.
Chulalongkorn University, host to the prestigious Faculty of Education, has only two professors teaching Counselling Psychology, Guidance and Special Education degrees.
The programme takes in an average of 20 students per year.
To ease the issue, Dr Amornwich said the Faculty of Education should offer scholarships for prospective students who have LD to create a generation of LD teachers intimately familiar with the experience of learning difficulties.
"What may be better is to attract students who themselves have had a LD and may wish to become LD teacher, since they can understand and may have a passion to teach kids with LD," he said.
In Project Chula-Lop Buri, Dr Amornwich sought to experiment with new learning systems. The project dispatched clinical psychologists to two pilot schools in Lop Buri province. Staff were shown the proper way to teach and manage special-needs students.
The area-based approach, using the geography as the main entry point for intervention, could spread to nearby schools if proven effective, said Dr Amornwich.
He said he hopes this could inspire more wide-reaching improvements across Thailand.
Dr Amornwich sees some potential for change in the Equitable Education Fund from 2016 proposed by the Independent Committee for Education Reform. He believes the fund plays a key role in closing the gap in the overall education inequality.
If given proper commitment by the government, the fund can stimulate the development of education that not only benefits children with special needs but those who may simply lack opportunities, he explained.
"The fund will be a great boost in dealing with not only the LD issue but inequality in education in general," Dr Amornwich said. "I want the government to take it seriously. I want them to commit to the improvement of mass education."