Alphabet problems linked with learning disability in children: a cross sectional study

Raghavendra K., Venkatesh Reddy A. N.


Background: Learning Disability (LD) is a frequently neglected entity in our set up, with the affected children being labeled as dull and worthless. The feeling of inadequacy and shame leads to psychological problems in approx. 30% of these children. These include low self-esteem, school phobia, anxiety, depression, oppositional-defiant behavior and conduct disorders. Early recognition of this disability in the primary school children and initiating appropriate remedial measures can significantly reduce morbidity. Authors objective was to study the prevalence and pattern of alphabet problems in children with learning disability.

Methods: This was a cross sectional study done in the Child Guidance Clinic of a tertiary care teaching hospital in Chitradurga district, Karnataka, between January 2016 and January 2018. After obtaining informed consent from parents, children between ages 5 to 17 years, diagnosed to have learning disability, were asked to write upper and lower case alphabets in English. Alphabet problem was diagnosed if child had mixing of upper and lower case alphabets, missing of alphabets, reversals and improper sequence. Association of alphabet problems with age and sex was studied.

Results: There were 293 children with learning disability, between 5-17 yr of age, attending our Child Guidance Clinic, who were assessed for alphabet problems. Alphabet problems were noted in 83.6% children. Mixing of upper and lower case alphabets was seen in 74.74%, missing of alphabets in 25.94%, reversal of alphabet in 21.50% and errors in sequencing in 12.97%. The prevalence of alphabet problems was higher in the 5-8yr age group. Prevalence of alphabet problems was more in males compared to females.

Conclusions: Alphabet problems were present in a significant number of children with learning disability. Presence of alphabet problems could be used as a simple screening tool for children with learning disabilities.


Alphabet problems, Learning disabilities, Scholastic backwardness

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