Improving the Self-Esteem and Social Skills of Students with Learning Disabilities
- James C. RainesJames C. RainesDepartment Chair of Health, Human Services and Public Policy at California State University Monterey Bay
Learning disabilities (LD) are the most common disability in public schools. Since 1975, students with learning disabilities have been eligible for a free appropriate public education, including special services such as school social work. Students with LD may be diagnosed via standardized achievement measures and clinical assessment. Despite 40 years of progress, the evidence suggests that students with LD still feel stigmatized and finish college and enter the workplace at a rate much lower than their nondisabled peers. School social workers can assist students with learning disabilities by assessing their self-esteem and social skills and then providing appropriate intervention. Self-esteem interventions should target students with LD, their parents, and their peers in the least restrictive environment. Social skills interventions may target students with LD as a separate group or provide those skills as part of universal inclusive education aimed at all children in the classroom.
Until the Education for All Handicapped Children’s Act of 1975 (P.L. 94–142), students with learning disabilities (LD) were routinely misidentified (treated as “mentally retarded”) or unidentified (treated as “slow learners”). Every social worker should be familiar with the federal definition of the term, which still relies on Samuel Kirk’s (1962) original conceptualization. “Specific learning disability” means:
a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual handicaps, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia . . . The term does not include children who have learning problems that are primarily the result of visual, hearing, or motor handicaps, or mental retardation, or emotional disturbance, or of environmental, cultural, or economic disadvantage.(Assistance to the States, 1999, 34 C.F.R. §300.7(b)(10))
The new Diagnostic & Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) designed to correlate with the International Classification of Diseases (10th ed.) provides four main criteria:
Difficulties learning and using academic skills, as indicated by the presence of at least one of the following symptoms (reading, comprehension, spelling, number sense, or mathematical reasoning) that have persisted for at least 6 months, despite provision of interventions that target those difficulties.
The affected academic skills are substantially and quantifiably below those expected for the individual’s chronological age, and cause significant interference with academic or occupational performance, or with activities of daily living, as confirmed by individually administered standardized achievement measures and comprehensive clinical assessment. For individuals age 17 and older, a documented history of impairing learning difficulties may be substituted for the standardized assessment.
The learning difficulties begin during school-age years but may not become fully manifest until the demands for those affected academic skills exceed the individual’s limited capacities.
The learning difficulties are not better accounted for by intellectual disabilities, uncorrected visual or auditory acuity, other mental or neurological disorders, psychosocial adversity, lack of proficiency in the language of academic instruction, or inadequate educational instruction. (pp. 66–67)
The DSM-5 allows specifiers to clarify the subtype of specific learning disability (reading, written expression, or math) and allows users to code the current severity (mild, moderate, or severe). Finally, the DSM-5 also acknowledges that a specific learning disability may manifest differently across cultures. For example, English-speaking students often exhibit inaccurate and slow reading of individual words, but students from cultures that possess a more direct correspondence between letters and sounds (e.g., Spanish) or students from cultures that use ideograms (e.g., Chinese) often exhibit slow but accurate reading.
Prevalence and Trends
Since the passage of P.L. 94-142, reauthorized as the Individuals with Disabilities Education Act (IDEA) in 1990, the number of youth found to have learning disabilities grew from 800,000 students in 1976–1977 to nearly 2.9 million students in 2000–2001. Since 2001, however, the percentage of students diagnosed with LD has steadily declined from 6.1% to 4.7% in 2011–2012, a decrease of 500,000 students (U.S. Department of Education, 2015a). Students with LD accounted for 50% of all students receiving special education services in 2000–2001 and represent the most common disability across all racial/ethnic groups even though they now account for about 40% of all students in special education (Zirkel, 2013). Students with LD are disproportionately (2/3) male, but female students may be underidentified (Cortiella & Horowitz, 2014). Students with LD are also disproportionately poor, twice as likely to be in foster care, and twice as likely to be homeless. Over two-thirds (68%) of students with LD complete high school on time compared to 81% of their peers (U.S. Department of Education, 2015b). Nearly a fifth (19%) drop out of school compared to just 7% of their peers (U.S. Department of Education, 2015c). Finally, less than half (46%) of working-age adults with LD report being employed compared to 71% of their peers. This trend is also true for adults with LD in other developed nations (Carroll, 2015).
There are some signs of improvement. More states are adhering to the principle of educating students with LD in the least restrictive environment so 66% of students with LD spend 80% or more of their school day in general education, up 19% since 2002. The number of students completing high school is up 11%, and the dropout rate has fallen 16% during the same time period. Students with LD report enrollment in postsecondary education within eight years of leaving high school at the same rate (67%) as their peers. Most Americans (79%) believe that students learn in different ways, and virtually all educators (99%) agree (Cortiella & Horowitz, 2014).
Unfortunately, only 17% of students with LD receive academic accommodations in postsecondary institutions. Thus the 4-year college completion rate for students with LD is 11% below their peers. There is continuing evidence that there is a stigma attached to having a learning disability. Only 2.2% of parents report that their children have LD compared to the 5% of students provided special education for LD. Likewise, only 2.7% of adults, ages 18–24, acknowledge having a learning disability despite the fact that P.L. 94-142 was passed over 40 years ago. Clearly, it is difficult to ask for academic accommodations if one is trying to deny having a disability. Finally, there was a 9% decline in employment among working-age adults with LD from 2005 to 2010. Only 5% of young adults report receiving vocational accommodations at their workplace (Cortiella & Horowitz, 2014).
The concept of self-esteem has evolved from focusing primarily on global measures to more nuanced approaches that recognize that self-esteem is multidimensional, including academic, emotional, physical, social, and other characteristics (Harter, 1999; Hymel, LeMare, Ditner, & Woody, 1999). School social workers should be cautious about assuming that all students with LD have self-esteem issues. While a number of multi-national studies have shown that students with LD may have mildly lower global self-esteem (Alesi, Rappo, & Pepi, 2012; Al Zyoudi, 2010; Krull, Wilbert, & Hennemann, 2014; Ntshangase, Mdikana, & Cronk, 2008), there is great variability among individuals. In general, they are more likely to have moderately lower academic self-esteem (Bear, Minke, & Manning, 2002; Zeleke, 2004), but even on this dimension scores can vary widely. Social workers are well advised to do a thorough assessment. Not all measurement instruments for self-concept are multi-dimensional. Recommended instruments include the Piers-Harris Children’s Self-Concept Scale (2d ed., PHCSCS-2; Piers, Harris, & Herzberg, 2002), the Self-Description Questionnaire (SDQ) instruments (Marsh, 1990a, b), the Self-Esteem Inventory (Coopersmith, 1986), and the Self-Perception Profile for Children (SPPC; Harter, 1982).
This difference is important for intervention. Not surprisingly, domains that are rated lowest are the ones that demonstrate the greatest response to intervention (Elbaum & Vaughn, 2003; O’Mara, Green, & Marsh, 2006). Elementary students’ self-esteem will benefit most from academic interventions rather than counseling. Strategy instruction and small group instruction are helpful. Middle school and high school students’ self-esteem will benefit most from counseling interventions (Elbaum & Vaughn, 2003). The most effective interventions are ones aimed at the children and their nurturing environment. While there are more recent interventions with an emerging evidence base, the interventions mentioned here have the advantage of being tested within a school system and having used follow-up studies to ensure that the effects are lasting.
Interventions with Parents
Interventions with parents are important because research has found that parents of students with LD actually hold lower expectations for their children’s educational attainment than the students themselves (Cortiella & Horowitz, 2014). Kuzell, Brassington, and Mahoney (1988) found that a 10-week parenting course was effective in improving the self-esteem of middle school children with LD both at the end of the course as well as a year later. The goals of the course include: (1) teaching general parenting skills; (2) exploring how to adapt these skills for children with LD; (3) providing current information on how parents can improve their child’s social and daily living skills; and (4) giving parents the chance to share their experiences in a supportive environment. Materials include both a leader’s manual and parents’ manual (Kuzell & Brassington, 1985). Raines (2013) recommended using two co-leaders with the following qualifications: motivation to lead, an understanding of learning disabilities, teaching skills, and knowledge of basic parenting techniques. He also recommended that leaders present the proposal to the following constituencies before implementation: school administrators, supplemental instructional service personnel (i.e., school social workers, psychologists, and special educators), and the parent association to elicit suggestions before beginning the group. Participation by 8–10 families is optimal, so that the larger group can be broken into two subgroups for skills practice.
The course is designed to last 2.5 hours one night a week for 10 consecutive weeks. Ideal seasons to offer the group include September to November or January to March because of the lack of holiday interruptions. Ideal nights are Mondays or Tuesdays so that routine weekdays follow during which the skills learned in the course can be practiced. A flier should contain information about the goals, leaders, time, place, cost, and registration procedures. Each week the course includes multisensory teaching about learning disabilities, some practical parenting concepts, and opportunities for parents to practice these skills in small groups. Because Kuzell & Brassington’s (1985) book is now out of print, the Learning Disabilities Council’s parent workbook (Trusdell & Horowitz, 2002) is recommended. Silver’s (2006) book for parents of students with LD may also be a helpful supplement.
Interventions with Students with LD
Lenkowsky et al. (1987) found that bibliotherapy in classroom groups was effective for middle school children (ages 12–14) with LD. Bibliotherapy involves students reading a story, identifying with a character, experiencing catharsis, and gaining new insight into their problem (Pardeck, 1998). This approach is especially appealing because it connects an academic means (reading) to a therapeutic end (self-esteem). The students read age-appropriate books (e.g., Albert, 1976; Swarthout & Swarthout, 1975) about other children with learning difficulties in a “literature” class that meets three times per week. They also participate in a weekly discussion group that addresses the feelings, mutual experiences, and school-related problems reflected in the books. This intervention involves collaboration between teachers, practitioners, and the school librarian to create a high fidelity program (Lynn, McKay, & Atkins, 2003). Language arts teachers should ensure that state reading standards are met, practitioners can facilitate the group discussions, and librarians can help determine which books are currently in print and available at a group discount. For students with reading difficulties, it may be best to choose a story that is also available on audiotape. It is important to select books that reflect developmental problems similar to the ones faced by the students.
Sridhar and Vaughn (2002) provide a list of sample questions to be asked before, during, and after reading Polacco’s (1998) story. Before reading the book, students are given a brief introduction (from the book’s preface) and asked to make hypotheses about the book and the outcome of the story. During the story, students are asked to paraphrase the plot and identify the emotions of the lead characters. After reading the book, students retell the story, recount similar personal experiences, and generate alternative solutions to problems shared.
Interventions with Nondisabled Peers
Fuchs et al. (2002) found that Peer-Assisted Learning Strategies (PALS), a form of peer academic tutoring, improved the social acceptance and social standing of students with LD. Other authors have also linked small group reading with social skills improvement (Miller, Fenty, Scott, & Park, 2011; Womack, Marchant, & Borders, 2011). Fuchs and colleagues’ finding is especially interesting in light of Mastropieri et al.’s (2000) meta-analysis, which found that tutors generally gained more from tutoring by students with disabilities than the tutees. PALS creates 12–15 pairs of students in a classroom who work collaboratively on different learning activities, such as reading or math. It may be beneficial for the teachers to be careful not to pair students with similar learning disabilities. The class is also divided into two teams. Students earn points for their team by correct performance and good collaboration. Thus PALS uses both competition and cooperation to motivate students. Teachers establish four classroom rules at the beginning: (1) talk only to your partner and only about PALS; (2) keep your voice low; (3) help your partner; and (4) try your best. The teacher gives direct instruction and clarifies understanding of each concept through a choral response. Each member of the pair takes turns being either the Coach (tutor) or the Player (reader). The teacher first gives direct instructions to the Players (e.g., “K sounds like kkk . . .”). The instructor then gives strategy hints to the Coaches (e.g., “Point to the letter and say, ‘What sound?’”) as well as appropriate praise statements (e.g., “You could say, ‘Awesome job!’”).
There are four PALS reading activities. The first activity is Partner Reading, during which the higher-performing student reads for 5 minutes and then the lower-performing student rereads the same material. As the Player works on the material, the Coach provides strategy hints. After both have read, the lower-performing student gets two minutes to retell what has happened. Students earn 1 point for each correctly read sentence and 10 points for the comprehension rehearsal. The second PALS activity is Paragraph Shrinking, during which the Player reads one paragraph at a time and tries to summarize the paragraph in 10 words or less. Students earn 1 point for correctly identifying the most important idea and 1 point for stating it in 10 words or less. The third PALS activity is Prediction Relay, during which the Player makes a guess about what will be found in the next half page. Students earn 1 point for each reasonable prediction, 1 point for accurately confirming or contradicting the guess, and 1 point for summarization (Fuchs, Fuchs, & Burish, 2000).The final step is Story Mapping, where each pair combines with another pair. Each of the four students takes a turn being the leader, who identifies one part of the story (lead character, setting, problem, and result) and one major event in the story. Each leader must follow a pattern of (1) telling their answer, (2) asking group members their ideas, (3) leading discussion toward a consensus, (4) recording the group’s answer on a story map, and (5) reporting the answer to the teacher. Finally, the teacher debriefs the group answers with the entire class. Each pair earns 10 points for collaborating, 2 points for each correct story part, and 1 point for each reasonable but incorrect story part (Fuchs, Fuchs, Mathes, & Martinez, 2002). During each of these steps, the teacher roams around the class giving extra points for cooperative behavior and good tutoring.
There are two kinds of social behavior problems that may need intervention. Skills deficits refer to a lack of learned behaviors. Performance deficits refer to a lack of motivation to employ skills already learned (Gresham, Van, & Cook, 2006; Kavale & Mostert, 2004). For skills deficits, intervention should be aimed at the students. For performance deficits, intervention should be aimed at parents and teachers who have the ability to cue, shape, and reinforce the execution of social skills. Thus, interventions for social skills can be done with both the students with LD and their nondisabled peers. Like self-esteem, multinational studies show that most students with learning disabilities have problems with social skills (Carman, & Chapparo, 2012; Schmidt, Prah, & Čagran, 2014; Yüksel, 2013), but there is wide individual variability (Nowicki, 2003). In general, students with nonverbal learning difficulties will have more social skills problems (Bloom & Heath, 2010; Glass, Guli, & Semrud-Clikeman, 2000; Palombo, 2006), but even these students can demonstrate great unevenness. Recommended instruments for assessing social skills include the List of Social Situation Problems (LSSP; Spence, 1980), the Matson Evaluation of Social Skills with Youngsters (MESSY; Matson, 1988), and the Social Skills Improvement System (SSIS; Gresham & Elliott, 2008).
Pull-out Interventions with Students with LD
Utay and Lampe (1995) found that the Social Skills Game by Berg (1989) was effective in improving the peer-related social skills of students with LD. They used the game with two groups of children in grades 3–4 and grades 5–6 for 50-minute sessions over 8 weeks. The game is designed to be used for children ages 8 and up. For younger children, a Social Thinking Skills Puppet DVD illustrates each skill. For older children (ages 10–16), the Social Skills Skits DVD features real kids. It includes three inventories to identify the students’ specific skill deficits, including a parent-teacher evaluation of social skills, a children’s self-report social behavior inventory, and a children’s self-report social cognition inventory. The inventories enable the group therapist to preselect game cards to address the specific problems. The game also teaches six cognitive skills that improve social interactions, including self-reinforcement, causal attribution, managing anxiety, learning from mistakes, building confidence, and positive expectations. The game cards address four social skill areas: (1) making friends; (2) responding positively to peers; (3) cooperating with peers; and (4) communicating needs. While the game can be played one-on-one, part of the effectiveness of the game is the group process itself. A newer resource is Plummer’s (2008) Social Skills Games for Children. Because students with LD should spend the least amount of time possible away from core academic subjects, clinicians should consider running such groups before school, during recess or lunch, or after school. Use of a “game” may also help these students from feeling like they are missing out on the “fun” if the group is held during nonacademic times.
A newer group intervention for children with nonverbal learning disabilities and children with autism spectrum disorder targets social perception (Guli, Semrud-Clikeman, Lerner, & Britton, 2013). The Social Competence Intervention Program (SCIP) is a 16-session manualized intervention program that uses creative drama activities (Guli, Wilkinson, & Semrud-Clikeman, 2008). Sessions 1 through 7 help students with the input stage of social perception through the following topics: group engagement, emotional knowledge, focusing attention, facial expressions and body language, vocal cues, and integrating multiple cues. Sessions 8 through 12 assist students with the interpretation of nonverbal cues through activities that focus on taking others’ points of view and interpreting conflicting cues. Students engage in several improvisations through which they practice perspective taking and cognitive flexibility. Sessions 13 through 16 aid students with the output stage of social perception and effective ways to respond to others.
Elksnin (1996), however, points out that while pull-out social skills instruction may be the norm, there are distinct advantages to inclusive social skills instruction. First, students with LD can be co-taught by a special education teacher and a general education teacher. Since students with LD spend the majority of the school day in general education, that teacher can provide prompts, reinforce appropriate social skills, and identify special problems that may require more intensive intervention. Second, coincidental instruction can enable both teachers and parents to address naturally occurring situations as opportunities for teachable moments. Finally, teachers and parents may be able to conduct social skills autopsies (Lavoie, 1994) to analyze social errors and help the student identify prosocial alternative actions for similar situations in the future. Hutchinson, Freeman, and Berg (2004) identify five principles for contextualized social competence education. First, the developmental interests, needs, and strengths of the students must inform the design of interventions. Next, building friendship between students with LD and their nondisabled peers should be an essential component of any program. Third, any program must be cognizant of the school context in which curriculum is delivered. Fourth, in schools where students change classes (e.g., middle or high schools), all teachers should be oriented to the social skills curriculum so that consistent expectations exist. Finally, interventions should focus on both how and when skills should be employed.
Inclusive Interventions with Students with LD
Embry (2002) found excellent results from the Good Behavior Game (Barrish, Saunders, & Wolf, 1969). It was created as a classroom management tool in which two to five intraclass teams compete to earn rewards for prosocial behavior (e.g., “Raise your hand to speak”). The game works by harnessing the positive peer pressure of the classroom teams, who work together reduce behaviors that interfere with learning and success. A strengths-based approach to the game in which positive rather than negative behaviors are monitored and rewarded is preferred (Tanol, Johnson, McComas, & Cote, 2010). It also appears to work effectively across diverse cultures (Nolan, Houlihan, Wanzek, & Jenson, 2014).
There is also a wide variety of whole classroom curriculums to teach social skills. These curricula are organized below by the amount of evidence supporting their effectiveness in schools and with follow-up studies that demonstrate lasting effects (Kelly, Raines, Stone, & Frey, 2010).
I Can Problem Solve (Shure, 2000) is an effective interpersonal cognitive program for young children through adolescents (Yekta, Davaei, Zamani, Poorkarimi, & Sharifi, 2013). The program has four components: structured lessons, classroom dialogues, curricular integration, and family exercises. The preschool version contains 59 lessons, the K-3 version has 83 lessons, and the 4th- to 6th-grade version provides 77 lessons. Unfortunately, the two versions for older children omit the family exercises provided in the preschool version. The program is available in both English and Spanish.
The Incredible Years (Webster-Stratton, 2011) is a set of three multifaceted and developmentally appropriate curricula for children (3–8 years old), teachers, and parents. The parent, teacher, and child programs can be used separately or in combination. The classroom program is typically offered two to three times per week for 20–30 weeks. There are also prevention and treatment versions of the parent and child programs for high-risk populations. The basic parent training program targets three different age groups: parents of babies and toddlers (ages 0–2.6), parents of preschoolers (ages 3–5), and parents of school-age children (ages 6–12). In randomized control trials (Baker-Henningham, Scott, Jones, & Walker, 2012; Webster-Stratton & Reid, 2010), the program has been shown to increase children’s social skills, feelings literacy, and problem-solving skills. The program is available in multiple languages including English, Spanish, Chinese, French, and Russian.
Second Step (Committee for Children, 2008) has developmentally focused programs for children in three academic groups: preschool/kindergarten (ages 3–5), elementary (grades 1–5), and middle school (grades 6–8). The preschool program focuses on executive-function skills and self-regulation in preparation for formal schooling. It covers skills for learning, empathy, emotional regulation, friendship skills, and transitioning to kindergarten. The middle school program focuses on communication, coping, and decision-making skills in preparation for the dangers of adolescence (e.g., bullying, peer pressure, and substance abuse). Each lesson includes introduction of a weekly concept, presentation of a story using videos, puppets, or story cards, and sample discussion questions (Brown, Jimerson, Dowdy, Gonzalez, & Stewart, 2012). The Second Step program has been used effectively in over 26,000 schools in 70 countries (Committee for Children, 2014; Schick & Cierpka, 2013).
Students with LD represent a vulnerable population that needs social work advocacy, intervention, and research. Despite 40 years of being eligible for academic and vocational accommodations, too few adults with LD are completing a four-year college degree and finding gainful employment. These achievements can be furthered through self-esteem and social skills interventions at an early age by school social workers. We also need systemic changes. First, we need to reduce stigma by focusing on learning “differences” more than learning disabilities. Second, we need to take a strengths perspective to this population and find their other multiple intelligences (Raines, 2003). No individualized education program team meeting should be complete without identifying how the identified student learns best and harnessing this strength to empower him or her to be successful in both school and life.
Council for Learning Disabilities. The Council for Learning Disabilities, an international organization composed of professionals who represent diverse disciplines, is committed to enhancing the education and quality of life for individuals with learning disabilities across the life span.
LD Online. LD OnLine seeks to help children and adults reach their full potential by providing accurate and up-to-date information and advice about learning disabilities and ADHD. It is a national educational service of WETA-TV, the PBS station in Washington, D.C.
Learning Disabilities Association of America. Since 1963, LDA has provided support to people with learning disabilities, their parents, teachers, and other professionals with cutting-edge information on learning disabilities, practical solutions, and a comprehensive network of resources.
RTI Action Network. The RTI Action Network is dedicated to the effective implementation of Response to Intervention (RTI) in school districts nationwide. Their goal is to guide educators and families in the large-scale implementation of RTI so that each child has access to quality instruction and that struggling students are identified early and receive the necessary supports to be successful.
National Center for Learning Disabilities. The mission of NCLD is to improve the lives of the one in five children and adults nationwide with learning and attention issues—by empowering parents and young adults, transforming schools and advocating for equal rights and opportunities.
Smart Kids with LD. The mission is to educate, guide, and inspire parents of children with learning disabilities or ADHD. Their aim is to help parents realize their children’s significant gifts and talents and to show that with their love, guidance, and the right support, their children can live happy and productive lives.
Teaching LD. The Division for Learning Disabilities of the Council for Exceptional Children is an international professional organization that aims to promote the education and general welfare of persons with learning disabilities.
Understood. Their goal is to help the millions of parents whose children, ages 3–20, are struggling with learning and attention issues. They want to empower parents to understand their children’s issues and relate to their experiences.
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