Specific Learning Disorder

.: PREFACE
ÖN SÖZ
PREFACE
Prof. Dr. Işık GÖRKER
Trakya Üniversitesi Tıp Fakültesi, Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları ABD, Edirne, Türkiye
Article Language: TR
Özgül Öğrenme Bozukluğu (ÖÖB); kişinin yaş ve aldığı eğitim göz önünde bulundurulduğunda okuma, yazma ve aritmetik alanlarında beklenenin altında performans göstermesi ile karakterize olup, DSM-5'te okuma bozukluğu (disleksi), yazılı anlatım bozukluğu (disgrafi) ve sayısal (matematik) bozukluk (diskalküli) olmak üzere 3 alt başlık ile tanımlanan nörogelişimsel bir bozukluktur. ÖÖB'nin klinik görünümü; bu alt tiplerinin yanı sıra, ÖÖB şiddet düzeylerine, çocuğun gelişimsel dönemi ve tanı yaşına, psikososyal ve eğitsel desteklere, ÖÖB'ye eşlik eden psikiyatrik bozukluklara ve uygulanan tedaviye göre değişiklikler gösterir. ÖÖB tanılı çocuklar, sözel ya da yazılı dili anlama veya kullanmada sorunlar yaşarlar. Bu sorunlar; dinleme, düşünme, konuşma, okuma, yazma, heceleme veya matematiksel işlemler yapma gibi akademik yaşamda önemi olan bu becerileri olumsuz olarak etkiler.

Özgül Öğrenme Bozukluğu; oluşumunda genetik yatkınlık ve aile yüklülüğü, gelişimsel ve bilişsel faktörler, konuşulan dil ile birlikte eğitim düzeyi ve sosyoekonomik durumu da içine alan çevresel faktörlerin rol oynadığı bir bozukluktur. Genellikle okulun ilk yıllarında görülürken, bazı çocuklarda daha ileri yaşlarda süregiden ciddi öğrenme güçlükleri görülebilmektedir. Bu çocuklarda ÖÖB tanısı eğitim başladıktan sonra, ergenlik ve hatta yetişkinliğin herhangi bir döneminde konulabilmektedir. ÖÖB'nin diğer psikiyatrik bozukluklarla birliktelik göstermesi, semptomların ciddiyetini artırmaktadır. ÖÖB ve Dikkat Eksikliği Hiperaktivite Bozukluğu eştanılı çocukların, eştanı almayan ÖÖB olanlara göre daha kalıcı olduğu belirtilmektedir. Bu nedenle, erken tanı ve tedavi girişimleri, ÖÖB insidansını ve yaygınlık oranlarını önemli ölçüde değiştirebilir. ÖÖB'de tedavi girişimleri erken başlatılmazsa, bu tanıya davranışsal ve duygusal semptomlar da eşlik edebilir. Tanı ölçütlerinin ve yapılandırılmış ölçeklerin kullanılması, konuşma dilinin özellikleri ve çevresel faktörlerin değerlendirilmesi, yaygınlık oranı sonuçlarının ve tedavi girişimlerinin belirlenmesinin, tanıyı ve eştanıların konulmasını daha özgül kılmada yardımcı olacağı düşünülmektedir. Okul öncesi dönemde ÖÖB bulgularının farkına varılmasından sonra düzenlenen eğitsel yaklaşım ve erken tedavi girişimlerinin, bu bozuklukla ortaya çıkabilecek zorlukları azaltacağı görüşü hakimdir.

Tedavi yaklaşımları erken yaşta başlatılmazsa, ÖÖB'li çocukların ve ergenlerin yaşamları, oluşan akademik başarısızlıkları nedeni ile olumsuz yönde etkilenir. Olguların yaklaşık %40'ında okulu bırakma görülür. Düşük akademik başarısızlık; özgüven eksikliği, sosyal ve davranışsal sorunlar, duygusal sorunlara neden olabilir. Bu durum, anksiyete bozukluklarına, depresif belirtilere, somatik yakınmalara, uyum sorunlarına ve gelecekte işlerini kalıcı olarak sürdürmede zorluklara yol açabilir.

Özgül Öğrenme Bozukluğu sadece akademik güçlüklerle sınırlı kalmamakta ve genellikle yaşam boyu bilişsel, eğitsel, mesleki, sosyal ve ruh sağlığı alanlarında sorun yaşanma riskini artırmaktadır. Bu nedenle erken fark edilmesi önemlidir. Tedavisinde, çocuğun sağlığı ve eğitiminden sorumlu tüm birimlerin içinde olduğu multidisipliner bir işbirliğine gereksinim vardır.

'Özgül Öğrenme Bozukluğu' başlığı altında oluşturduğumuz bu kitabmızda araştırmacı yazarlarımız, ÖÖB'nin tanımlama ve klinik özelliklerini, yaygınlığı ve cinsiyet farklılıklarını, etyolojisi ve risk faktörlerini, değerlendirme sürecinde uygulanan girişimleri, eşlik eden eştanıları, ayırıcı tanıları, prognoz ve prognozu etkileyen faktörleri ve tedavi yaklaşımlarını derlemişlerdir. Ülkemizde çocuk ve ergen yaşta kendisini gösteren bu bozukluğun tedavisinin, ileri yaşlarda gelişebilecek bilişsel, eğitsel, mesleki, sosyal sorunların, eşlik edebilecek psikiyatrik bozuklukların önlenebilmesi açısından büyük önem taşıdığına inanıyor ve değerli yazarlarımızın oluşturduğu bu kitabın ÖÖB literatürüne bir katkı oluşturacağına inanıyoruz.

Prof. Dr. Işık GÖRKER
Editör
Specific Learning Disorder (SLD) is a neurodevelopmental disorder characterized by lower-than-expected performance in reading, writing and arithmetic given the age and education the person receives, and is defined in DSM-5 by three subheadings: reading impairment (dyslexia), written expression disorder (dysgraphia) and numerical (mathematics) disorder (dyscalculia). In addition to these subtypes, the clinical appearance of the SLD varies according to the levels of SLD severity, the developmental period and the diagnosis age of the child, psychosocial and educational support, the co-occurring psychiatric disorders and the treatment applied. Children who receive this diagnosis have problems understanding or using, verbal or written language. These problems negatively affects these skills, which are important in academic life such as listening, thinking, speaking, reading, writing, hyphenating or performing mathematical operations.

Genetic predisposition and family load, developmental and cognitive factors, education level and socioeconomic status, as well as spoken language, play a role in the Specific Learning Disorder development. While it is usually seen in the early years of school, some children may experience serious learning difficulties that continue at an older age. In these children, SLD could be diagnosed after the start of education, at any time of the adolescence or even the adulthood. If the SLD co-occur with other psychiatric disorders, the severity of the symptoms increases. It is stated that children with SLD and Attention Deficit Hyperactivity Disorder are more permanent than those who do not have the comorbidity. Therefore, early diagnosis and treatment interventions can significantly change the incidence and prevalence rates of SLD. If the treatment interventions are not initiated early in SLD, it may also be accompanied by behavioral and emotional symptoms. It is thought that the use of diagnostic criteria and structured scales, evaluation of the characteristics of the spoken language and environmental factors, prevalence rate results and determination of treatment interventions will help to make the diagnosis of the SLD and the comorbidities more specific. It is stated that educational approach and early treatment interventions organized after the awareness of the SLD findings in the preschool period will reduce the difficulties that may arise with this disorder.

If treatment approaches are not initiated at an early age, the lives of children and adolescents with SLD are adversely affected by their academic underachievement. Approximately 40% of cases have dropouts from the school. Academic underachievement could cause lack of self-confidence, social and behavioral problems, and emotional problems. This can lead to anxiety disorders, depressive symptoms, somatic complaining, adaptation problems and difficulties in sustaining their jobs in the future.

Specific Learning Disorder is not limited to academic difficulties and generally increases the risk of problems in the areas of cognitive, educational, professional, social and mental health in lifetime. Therefore, it is important to detect early. In its treatment, multidisciplinary cooperation is needed, including all units responsible for the health and education of the child.

In this book, which we have created under the title of 'Specific Learning Disorder', our researchers have compiled the identification and clinical characteristics of SLD, prevalence and gender differences, etiology and risk factors, interventions applied in the evaluation process, comorbidities, differential diagnoses, factors influence the prognosis and the treatment approaches. We believe that the treatment of this disorder which manifests itself in children and adolescents in our country, is of great importance in terms of preventing cognitive, educational, professional, social problems that may develop in older age, and we believe that this book composed by our esteemed authors will make a contribution to the SLD literature.

Prof. Dr. Işık GÖRKER
Editor

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