Learning Disabilities in Older Adolescents and Adults: Clinical Utility of the Neuropsychological Perspective

252 Pages·2001·1.44 MB·English

by  Lynda J. Katz

Learning Disabilities in Older
Adolescents and Adults
CRITICAL ISSUES IN NEUROPSYCHOLOGY

Series Editors
Antonio E. Puente Cecil R. Reynolds
University of North Carolina at Wilmington Texas A&M University
and Bastrop Mental Health
Associates
Current Volumes in this Series
HANDBOOK OF CROSS-CULTURAL NEUROPSYCHOLOGY

Edited by Elaine Fletcher-Janzen, Tony L. Strickland, and Cecil R. Reynolds

INTERNATIONAL HANDBOOK OF NEUROPSYCHOLOGICAL

REHABILITATION

Edited by Anne-Lise Christensen and B. P. Uzzell

LEARNING DISABILITIES IN OLDER ADOLESCENTS AND ADULTS

Clinical Utility of the Neuropsychological Perspective

Lynda J. Katz, Gerald Goldstein, and Sue R. Beers

MEDICAL NEUROPSYCHOLOGY, Second Edition

Edited by Ralph E. Tarter, Meryl Butters, and Sue R. Beers

NEUROPSYCHOLOGICAL INTERPRETATION OF OBJECTIVE

PSYCHOLOGICAL TESTS

Charles J. Golden, Patricia Espe-Pfeifer, and Jana Wachsler-Felder

NEUROPSYCHOTHERAPY AND COMMUNITY INTEGRATION

Brain Illness, Emotions, and Behavior

Tedd Judd

PRACTITIONER’S GUIDE TO EVALUATING CHANGE WITH INTELLECTUAL

ASSESSMENT INSTRUMENTS

Edited by Robert J. McCaffrey, Kevin Duff, and Holly J. Westervelt

PRACTITIONER’S GUIDE TO EVALUATING CHANGE WITH

NEUROPSYCHOLOGICAL ASSESSMENT INSTRUMENTS

Edited by Robert J. McCaffrey, Kevin Duff, and Holly J. Westervelt

RELIABILITY AND VALIDITY IN NEUROPSYCHOLOGICAL ASSESSMENT,

Second Edition

Michael D. Franzen

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information please contact the publisher.
Learning Disabilities in Older
Adolescents and Adults
Clinical Utility of the Neuropsychological
Perspective
Lynda J. Katz
Landmark College
Putney, Vermont
Gerald Goldstein
VA Pittsburgh Healthcare System and
University of Pittsburgh
Pittsburgh, Pennsylvania
and
Sue R. Beers
University of Pittsburgh
Pittsburgh, Pennsylvania
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PREFACE

While numerous books have been written on diagnostic practices and interven­
tion strategies for school-age children, much less information is available for the
clinician and educator who works primarily with older adolescents and young
adults who meet criteria for a diagnosis of a specific learning disorder and/or
attention deficit disorder (ADHD). Many psychologists, including the authors of
this book, specialize in the area of neuropsychology. In particular, we have
worked with adolescents and young adults who seek evaluations to determine
the presence a learning disorder more typically diagnosed in childhood because
of the significant negative impact they have begun to experience in their later
academic or vocational career. Because they had not been previously diagnosed
despite, often times, ongoing concerns of parents and significant others, they
come to the attention of clinicians as diagnostic dilemmas in many instances.
Comorbidity issues emerge as these individuals enter the young adult years,
some of which have necessitated treatment at one point or another. Clinicians
who will be sought out to conduct assessments, document the presence of a dis­
ability, and offer recommendations regarding treatment/interventions and rea­
sonable accommodations will be required to have a comprehensive knowledge
of the various aspects of language based learning disorders, what constitutes
nonverbal learning disorders and high functioning autism, and how attention
deficit disorders are typically manifest in adults in order to competently address
the complex diagnostic and treatment issues raised.
This book is an effort to provide a comprehensive review of what we know
about certain of these disorders, specifically, disorders of reading and written
expression, mathematics, nonverbal learning disorders (NVLD), high function­
ing autism, and ADHD, as they manifest in the lives of young adults. It will
readily become apparent to the reader that hotly contested controversies sur­
round the diagnostic methodologies employed across the learning disorders (one
of which is not even categorized in the DSM-IV) and ADHD. In addition, how
to intervene and the effectiveness of any given intervention in the later years of
development and maturity are open for investigation. Much of what we know is
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vi PREFACE
descriptive in nature as research involving adults has only recently begun to
emerge in the literature. As more work clarifies diagnostic issues in childhood
and the public at large grows increasingly concerned with academic failures in
the high school years and beyond, researchers will be asked to deal with these
concerns as well. In addition, just as many students with diagnosed learning
disorders and/or ADHD have begun to benefit from special education laws or
504 Plans in their elementary and secondary school years, recognition of the
need for ongoing services or accommodations in postsecondary settings and in
the work place have been challenged in the courts. The Boston University deci­
sion as well as several other court cases sent a message to those professionals
involved in the diagnostic process, defining to some degree the nature of docu­
mentation required for disability status under the law.
It was with these concerns in mind that we set out to write this book. Not only
did we want to bring a historical perspective to the subject matter, but we also
wanted to document relevant research including that from areas outside of the
strict domain of neuropsychology (psychopharmacology, educational psychol­
ogy, neurology) in order to give as holistic a picture as possible. Our own neu­
ropsychological training and work experiences color our review to be sure, but
because we attempted to remain true to underlying values concerning the need
for comprehensiveness and ecological validity, we do not apologize for our bias.
The book is divided into five chapters, each one addressing one of the disor­
ders of learning mentioned above. If particular studies pertained to more than
one topical area, we made efforts to refer the reader to the more complete dis­
cussion of that area. Each chapter is divided into sections dealing with historical
perspectives, definitions and diagnostic criteria, incidence and prevalence data,
comorbidity studies, pertinent research from neurophysiology, neuropsychology,
neuroimaging, and psychopharmacology where appropriate, educational psy­
chology and special education studies, reasonable accommodations in academics
as well as the workplace, and outcome data. Obviously, some of the disorders
have been less well researched in the adult literature (e.g., math disorders,
NVLD, autism), but we attempted to provide as thorough a perspective for the
practicing clinician as was possible. We have made efforts also to refer the
reader to more comprehensive reviews on particular aspects of the various dis­
orders when appropriate. Finally, the reference list at the end of the book pro­
vides an excellent resource in its own right. We learned from each other as we
wrote this book; we hope that our readers will have that same experience.
Lynda J. Katz
Gerald Goldstein
Sue R. Beers
ACKNOWLEDGEMENTS
We wish to extend our special thanks to Gladyce Coval, Executive Assistant to
the President of Landmark College (one of the authors, Lynda J. Katz) who
worked tirelessly throughout the production of this book and who assured the
production of our final manuscript. We would also like to acknowledge the
contribution of Dr. Michael McCue, who was an early collaborator on much of
our own research and teaching in the area of adults with learning disability. We
also want to thank our respective organizations, Landmark College, the
Department of Veterans Affairs, and Western Psychiatric Institute and Clinic for
their support of this work.
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CONTENTS
Reading and Writing Disorders 1

Mathematics Disorder 43

Nonverbal Learning Disability 69

ADHD 105

High Functioning Autism 149

Concluding Thoughts 179

References 185

Index 231

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